Aortic Dissection with Intimal Flap in SMA

This patient presented with acute abdominal and chest pain. This image from a spiral CT scan of the abdomen is diagnostic of an acute abdominal aortic dissection (arrow). In an aortic dissection, blood enters the wall of the aorta (the main blood vessel leading from the heart) and tears ("dissects") the wall, creating a true lumen and a false lumen. The true lumen is separated from the false lumen by a piece of tissue known as an intimal flap; the intimal flap can be seen in this case extending into the proximal aspect of the superior mesenteric artery, one of the major blood vessels of the abdomen.