{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T22:26:51Z","timestamp":1777415211783,"version":"3.51.4"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":285,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Medicine"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>This report underscores the urgent necessity of early and accurate diagnosis in cases of aortic dissection (AD) with atypical presentations. A 76\u2010year\u2010old male presented to Al\u2010Zahra Hospital in Isfahan, Iran, with a 7\u2010day history of left flank pain radiating to the left testicle and groin, accompanied by fever, hematuria, and dysuria. Initial assessments, including a kidney and urinary tract ultrasound, revealed severe left kidney hydronephrosis and free fluid, leading to a preliminary diagnosis of pyelonephritis with a possible abscess. Broad\u2010spectrum antibiotics were promptly administered. However, a subsequent CT scan revealed a retroperitoneal hematoma, prompting a CT angiography (CTA), which confirmed an abdominal AD. Despite rapid surgical intervention, the patient succumbed to cardiac arrest. This case highlights the critical importance of vigilance and thorough investigation in patients with atypical symptoms to prevent potentially fatal misdiagnoses.<\/jats:p>","DOI":"10.1155\/carm\/6694346","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T06:50:01Z","timestamp":1760424601000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Diagnostic Dilemma: Abdominal Aortic Dissection Masquerading as Pyelonephritis"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8430-9920","authenticated-orcid":false,"given":"Elahe","family":"Nasri Nasrabadi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8567-5119","authenticated-orcid":false,"given":"Keihan","family":"Golshani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0236-6546","authenticated-orcid":false,"given":"Mehdi","family":"Nasr Isfahani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"e_1_2_14_1_2","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2002.125028"},{"key":"e_1_2_14_2_2","first-page":"70","article-title":"Abdominal Aortic Dissections: Anatomic and Clinical Features and Therapeutic Options","volume":"32","author":"Borioni R.","year":"2005","journal-title":"Texas Heart Institute Journal"},{"key":"e_1_2_14_3_2","doi-asserted-by":"publisher","DOI":"10.2174\/1573403X16666201014142930"},{"key":"e_1_2_14_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10016-004-0171-x"},{"key":"e_1_2_14_5_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.1704109"},{"key":"e_1_2_14_6_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.54343"},{"key":"e_1_2_14_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2021.11.047"},{"key":"e_1_2_14_8_2","doi-asserted-by":"publisher","DOI":"10.2177\/jsci.39.91"},{"key":"e_1_2_14_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000087386.07204.09"},{"key":"e_1_2_14_10_2","volume-title":"Aortic Dissection","author":"Levy D.","year":"2023"},{"key":"e_1_2_14_11_2","unstructured":"D\u2019SouzaD. KnipeH. WilczekM.et al. DeBakey Classification of Aortic Dissection 2025 https:\/\/radiopaedia.org\/articles\/debakey-classification-of-aortic-dissection."}],"container-title":["Case Reports in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/carm\/6694346","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/carm\/6694346","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/carm\/6694346","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T17:56:36Z","timestamp":1773770196000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/carm\/6694346"}},"subtitle":[],"editor":[{"given":"Anand","family":"Pandey","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/carm\/6694346"],"URL":"https:\/\/doi.org\/10.1155\/carm\/6694346","archive":["Portico"],"relation":{},"ISSN":["1687-9627","1687-9635"],"issn-type":[{"value":"1687-9627","type":"print"},{"value":"1687-9635","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-01-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"6694346"}}