Dissecting thoracic aortic aneurysm in a 22-year-old man

A 22-year old man presented with a 12-hour history of acute epigastric pain associated with hematochezia. Emergency echocardiography and aortography were diagnostic of a bicuspid aortic valve and dissection of the thoracic aortic aneurysm. Surgical intervention included repair of the aneurysm, partial small bowel resection, and revascularizations of the superior mesenteric artery. An eventful hospital course ended in the patient's death on the eighth postoperative day. Dissecting aortic aneurysm is a rare condition in young adults. Prompt diagnosis with aggressive medical management and urgent surgical consultation affords the best outcome.