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Objectives: Aortic dissection is a life-threatening condition, with a high mortality rate. It can be classified into Stanford type A or type B. This study reports the clinical presentation, risk factors, systolic blood pressure, and the mortality rate of patients with confirmed aortic dissection on computed tomography (CT) imaging. Mortality rate on weekends, weekdays, daytime, and night-time were also reported. Methods: A retrospective review of electronic health records of all patients requiring CT aortogram in the emergency department (ED) between 2013 and 2022 were examined. Patients with confirmed acute aortic dissection on CT were included. Presenting symptoms, demographics, and mortality rate were described and reported for type A and type B aortic dissection. Results: Of 315 patients, 65 had confirmed acute aortic dissection on CT imaging. The mean age at presentation was 50.6 years and the majority of the cohort were male (83%). Chest pain was the most common symptom (43%). A history of hypertension was present in 65% of the subjects. D-dimer was elevated in 95% of the patients. The overall in-hospital mortality was 18.5%, with a mortality rate of 40% in type A aortic dissection. Conclusion: Aortic dissection can occur with various symptoms, and therefore, requires a high index of suspicion. Chest X-ray has a low sensitivity in detecting aortic dissection and should not be used to rule out aortic dissection. D-dimer can be used as a diagnostic assay in ruling out aortic dissection. Type A aortic dissection has the highest mortality rate and hence necessitates prompt intervention.

Background: Dental needle aspiration is a rare complication of oral procedures given the advances in medical technology. Aspirations in general may also be asymptomatic, apart from the possible remote history of upper airway irritation at the time of induction. Clinicians should take a detailed history and examination, along with appropriate diagnostic imaging before discharging these patients from the emergency department. Case presentation: A young patient presented with an acute complaint of pain and coughing post-dental procedure. On arrival at the emergency department, she was vitally and clinically stable, without signs of respiratory distress. There were no complaints reported apart from minor throat pain. Imaging done in the emergency department revealed the presence of a 32 mm needle in the distal airway. She underwent emergency flexible bronchoscopy, and the foreign body was removed under direct visualization. The patient remained stable throughout the procedure and had an uneventful stay until discharge. Conclusion: While needle aspiration is a relatively uncommon occurrence, its early detection is always critical before further damage to local structures can occur. Regardless of presentation and symptoms, basic imaging is mandatory before the disposition is decided. [SJEMed 2024; 5(1.000): 058-060]