CREATINE-KINASE ISOENZYME PATTERN IN COLONIC INFARCTION CONSEQUENT TOACUTE AORTIC DISSECTION - A CASE-REPORT

Bowel infarction can complicate acute aortic dissection (AAD); in that case early diagnosis, which decreases the high mortality, is often di fficult. We report the case of one patient who underwent surgery for A AD and developed a colonic infarction, which was clinically manifest o n the 4th postoperative day. However, bowel ischemia was suspected alr eady 48 hours after surgery, on the basis of the suggestive CK pattern and the absence of myoglobin in plasma. Total CK activity reached the highest level only 48 hours after surgery (92.800 U/1); the peak was coincident with LDH, which increased proportionally less; CK-MM consti tuted 100% of total CK activity. The absence of myoglobin in plasma ex cluded the presence of rhabdomyolisis. We conclude that such laborator y findings suggest the occurrence of severe bowel ischemia.