Aortic Dissection Complicated by Mesenteric Malperfusion Syndrome Presenting As Hepatic Ischemia: A Case Report and Literature Review

Aortic dissection (AD) is a medical emergency that occurs as a result of a compromise in the structural integrity of the aorta. If left untreated, AD can have severe consequences such as organ dysfunction or even death. Malperfusion syndrome is a major complication of aortic dissection with mesenteric malperfusion syndrome being a rare but devastating form that can lead to mesenteric ischemia and is associated with poor prognosis despite timely management. Here we report a case of a 31-year-old woman who was diagnosed with mesenteric ischemia secondary to incidental findings of aortic dissection whilst being investigated for ischemic hepatitis. She underwent emergency surgery to repair the aortic dissection but faced challenges due to unusual arterial vasculature. Despite best efforts, the patient's condition deteriorated, leading to severe brain injury. Management of aortic dissection complicated by mesenteric malperfusion remains a clinical challenge with high mortality rates and despite this, there is currently no definitive national guideline for the best management approach.