| Summary: | Aortic dissection (AoD) is one of the most common catastrophes involving the aorta. Nevertheless, early diagnosis remains to be a challenge in the emergency department (ED), particularly in young individuals. The diagnosis of acute AoD is often delayed secondarily to its propensity to masquerade as other illnesses (i.e., renal colic, spinal-cord injury, and acute cauda equina syndrome) that result in acute lower-back pain (LBP). Here, we report a 38-year-old man who presented to our ED because of acute LBP with one leg numbness and weakness. It was subsequently found to have acute Type A AoD. This young man was diagnosed early in the ED and treated promptly without major adverse sequelae. We highlight that ED physicians should always keep high alertness in vascular emergencies (i.e., acute AoD), whilst engaging a patient with an acute-onset severe LBP with one leg numbness and weakness.
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