Acute type a aortic dissection discovered by point of care ultrasonography (POCUS) in a patient with atypical abdominal pain: a case report

Acute aortic dissection (AAD) is a life-threatening emergency with a worldwide incidence of approximately 4.8 per 100,000 individuals annually. While chest pain is the hallmark symptom, atypical presentations like abdominal pain can lead to significant diagnostic delays.

A 51-year-old male with hypertension presented with sudden, severe generalized abdominal pain. Physical examination revealed a rigid, tender abdomen and initial laboratory findings showed anemia (Hb 82 g/L) and elevated D-dimer.

Bedside point-of-care ultrasonography (POCUS) was immediately performed, identifying an intimal flap in the aorta. Subsequent CT angiography confirmed a Stanford Type A dissection extending from the aortic valve to the common iliac arteries.

This case highlights the critical role of POCUS in the rapid diagnosis of AAD in patients with atypical symptoms. High clinical suspicion and early ultrasound intervention are essential for improving survival in unstable patients.