Background: Aortic dissection (AD) is a catastrophic condition that represents a challenging diagnosis for emergency physicians. Its presentation can vary widely and may present with non-specific symptoms. A delay in the diagnosis of AD is associa ted with a high rate of morbidity and mortality. Case Presentation: A 77-year-old man presented to the emergency department with a history of acute epigastric abdominal pain and bilateral lower limb weakness. A suspected AD was confirmed by urgent computed tomography angiography in less than 1 hour; which showed extensive dissection of his aorta from ascending part up to the abdominal aorta; “DeBakey1.” The emergency complex aortic repair was then performed by the cardiothoracic surgical team that had resulted in a successful fortunate recovery. Conclusion: DeBakey type1 AD is a serious cardiovascular surgical emergency, with a dismal prognosis if missed in the emergency room. Our prompt diagnosis and expedited approach in handling this case led to successful recovery.

Keywords: Aortic dissection, DeBakey type1, computed tomography angiography, acute paraplegia, ischemic neuropathy, bentall pProcedure.