A case of giant syphilitic Stanford type a aortic dissection with right pulmonary artery compression presenting as facial swelling.

BACKGROUND

This article reports in detail a case of syphilitic aortic dissection (AD) with facial swelling as the initial symptom.

CASE PRESENTATION: A 62-year-old male had a 2-week history of facial swelling. CT examination revealed ascending aortic aneurysm and thrombosis. Computed tomography angiography (CTA) revealed ascending AD aneurysm and multiple ulcers. Syphilis antibody positive. Blood oxygen saturation was 92%-96%. The patient underwent ascending aortic replacement, total arch replacement, and elephant stent implantation 2 days after admission. The superior vena cava pressure decreased from 65 to 19 mmHg after surgery. The patient was extubated 6 h after surgery and was active the next day. Blood oxygen saturation returned to normal, and facial swelling reduced. CTA at 1 week confirmed the surgery's success.

CONCLUSION

This case underscores the rarity of syphilitic AD presenting as facial swelling. Timely recognition and individualized treatment strategies can achieve favorable outcomes.