Dissecting aortic aneurysm of a patient with suspected polymyalgia rheumatica

A 62-year old patient was admitted to the rheumatology ward because of weakness, easy fatigue, fever, pain of the shoulder and pelvic girdle not improving after NSAIDs. Considering the patient’s examination and additional findings, polymyalgia rheumatica was suspected. The patient received corticosteroids, after which he felt better and a decrease of ESR was noticeable. Next the patient felt acute abdominal pain and since then he has suffered from constant abdominal pain and loss of weight. After some time blindness of the left eye and flaccid paresis of the left lower limb and the right upper limb appeared. Due to purulent colitis and liver failure the patient was directed to the Gastroenterology Clinic in Poznan, where angio-CT was done. This examination revealed dissecting aneurysm of the thoracic and abdominal aorta. After the cardio-surgery consultation the patient was directed to the cardio-surgery ward for further treatment.

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