Aortic hematoma

At the end of November or beginning of December, I experienced excruciating mid to lower quadrant abdominal pain and went to hospital via an ambulance. When ambulance crew arrived I was unable to move my legs experiencing lower extremity paralysis that lasted approx 20min to 30 minutes with returned feeling slowly. At the hospital I was treated for uncontrollable blood pressure at times 200's over upper high 180's to 190 with multiple IV infusions for pain control and antihypertensive agents. Blood pressure was very difficult to get stabilized and then I was air lifted to a Boston Hospital and ICU managed me with multiple IV lines and continued to manage my blood pressure. I was diagnosed, prior to being air lifted with an abdominal aortic hematoma. At the Boston hospital, as documented, the same treatment continued with management of HTN and Pain control. Surgical intervention was not recommended at this time. Multiple CT SCANS were done to monitor and evaluate status. Since this time I have experienced ongoing abdominal discomfort which has gotten worse. I can only eat small portions, for example a 1/4 of a sandwich will make me feel bloated as if I had eaten a whole 4 coarse meal. My wife has gotten me Ensure to provide me with some nutritional status. I have had no blood in my stool just the continued abdominal pain with an inability to provide myself with an adequate intake with weight loss. Last Friday I had an endoscopy performed by my GI and he took a biopsy. The upper small intestine pathology report came back negative for abdominal cancer and the Doctor reported no H-Pylori and no infection was noted. However it did report noting a ‘severe irritation’. He gave me no other information about how to proceed with treatment of this and I wonder if this is related to my aortic hematoma with experiencing the paralysis. I would think that if there was ischemic tissue this would indeed cause an infection. Do or could you give me some idea as to why this is causing so much discomfort. I did have a follow up with a cardiologist who recommended a cardiac esophageal echocardiogram and the cardiologist reported a small place that was still in the process of healing. NO other concerns reported as result of this testing. DO YOU HAVE ANY IDEA's or HAVE YOU IN YOUR PRACTICE COME ACROSS ANOTHER INDIVIDUAL that presenting with similar or exact symptomatology?

Aortic hematoma

Aortic hematoma is a condition where bleeding occurs in the aortic wall without a tear. If a tear occurs this is known as aortic dissection. Both these conditions are potentially life threatening so you have done very well to have made such a good recovery, albeit with the symptoms you described. It is associated with bleeding disorders, hypertension, connective tissue disorders such as Marfans syndrome and Ehlers-Danlos syndrome as well as trauma. Yours has been treated conservatively as you describe, the most important thing being blood pressure control as you describe. Surgery is also sometimes undertaken.

The discomfort you are experiencing may well be ischaemic, where the blood flow to your organs is reduced and this results in pain similar to angina (where blood flow is reduced in the coronary arteries). The severe irritation you describe is probably gastritis or an inflammation of the stomach. This is usually treated with drugs called PPI?s although, in your case, it may be caused be ischemia, which can only be treated with pain relief. I suspect with time your symptoms will settle, but you have to be patient. That aside, it is very difficult for me to fully comment on your case due to its complexity, but you must keep a dialogue with your doctors on this. The Ensure drinks are an excellent idea. You might like to discuss with your doctors whether nitrate medications may help you too. Thank you for your enquiry about aortic hematoma.

My name is Dr Peter Thatcher MBBS, MRCPI and I am a consultant physician and gastroenterologist in the UK. I have an interest in internet based medicine and administer this site in my spare time. I hope you find this site useful and informative. If you have any suggestions, please Contact Me or if you would like to comment on my site, please do so by Click Here. If you like the site and would like to make a donation to support what I am doing please do so by Clicking Here. Thank you for visiting and please drop by again!