Christine Seppi was more than 1,500 miles away from home when her painful symptoms started.
Seppi and her husband traveled from their hometown of Pittsburgh to visit family in Utah when she started feeling severe pain in her lower abdomen and back. Although Seppi has digestive issues that can sometimes cause pain and discomfort, this felt more intense than usual.
It was late at night when the pain first hit—around 11:00 pm.
“Suddenly I had incredibly intense pain in my lower abdomen and my low back,” Seppi said. “It was like a ring of pain around my body, and it felt like my spine in my low back was going to break.”
Initially, Seppi wondered if her eating patterns were the root cause of her painful symptoms.
“I hadn’t been eating particularly normal since we had arrived in Utah,” she said. “We were traveling and out of our regular routine.”
Seppi tried reading a book to distract herself from the pain, but that didn’t work. She took a warm bath, drank some herbal tea, and tried a heating pad. After a second warm bath, she was finally able to fall asleep around 3:00 am and get a few hours of rest.
When she woke up at 7:00 am, the pain was still there, but not as bad as it had been. Suspecting a bladder infection, Seppi called her doctor’s office back in Pittsburgh to talk to a nurse.
“The nurse agreed that it sounded like a bladder infection and advised me to go to urgent care,” Seppi said.
After waiting for several hours in the waiting room, Seppi finally got to see a nurse around noon. Based on the location of the pain, this nurse also suspected Seppi had a bladder infection. However, the urine sample came back clean. An x-ray ruled out a bowel obstruction. A CT scan was the next step.
A Rare and Dangerous Diagnosis
At this point, Seppi was referred to the emergency room at University of Utah Hospital, where blood pressure and EKG results were normal. Seppi gave blood samples and got saline through an IV to help her stay hydrated since she had been without food and water for several hours. She also had a CT scan.
Around 6:30 pm, a doctor from the vascular surgery group gave Seppi the results of her CT scan.
“He told me I had an abdominal aortic dissection,” Seppi said. “And he told me not to Google it.”
A dissection is a tear in the blood vessel layers that can cause blood to pool between the layers. Dissections can happen anywhere in the body but are most often found in the aorta, the main blood vessel in your body.
Most patients with an aortic dissection can manage their condition through blood pressure control and medication. However, for some patients, an aortic dissection can be life-threatening.
This was the case with Seppi, due to the location of her dissection and her persistent pain. While aortic dissections aren’t uncommon, it is rare for one to occur in the abdomen.
Seppi was also in extreme pain. “I was a 15 out of 10 on the pain scale,” she said.
The first step of treating any aortic dissection is pain management through medication and controlling blood pressure levels.
“Once the pain is under control, we then decide what else needs to be done to treat the dissection,” said Cali Johnson, MD, EdD, a vascular surgeon at 鶹ѧƷ. “Most of the time, we don’t need to do anything else beyond medical management in the acute setting.”
Unfortunately, Seppi’s pain levels never got under control.
“This told us she was at risk of rupturing her aorta, which can be life-threatening,” Johnson said.
After a week in the hospital, Johnson let Seppi know that the medications were not working. A CT scan also showed that the dissection was getting worse. Johnson and her team decided, along with Seppi, that surgery was the best option. It didn’t come without its risks.
Innovative Surgery at U of U Health
“The problem with an abdominal aortic dissection is that there’s a bunch of important arteries coming off the aorta at the belly level,” Johnson said. “To complicate things further, there currently aren’t any stents on the market that could treat the area that she needed fixed.”
On January 10, 2023, Johnson and the vascular surgery team repaired Seppi’s aortic dissection.
Johnson made a —to fix Seppi’s aortic dissection. The stent was placed from inside the blood vessels near the tear. Smaller stents extended into the arteries for her kidneys and intestines, which connected to the openings in the main aortic graft.
“It’s kind of like building a ship in a bottle,” Johnson said.
Seppi spent two weeks recovering in the hospital after her surgery. She spent another week at her daughter’s house in Salt Lake City before she flew home to Pittsburgh at the end of January.
Before returning to Pittsburgh, Seppi met with Johnson for a final checkup.
“It was really nice of Dr. Johnson to adjust her schedule to see me before I left Utah,” Seppi said. “She also gave me a very realistic idea of how long my recovery would take, and I really appreciated that.”
Recovery, Gratitude, and a Future of Impact
Since surgery, Seppi meets with her vascular surgeon in Pittsburgh for regular follow-up appointments and yearly CT scans. As difficult as it was to have a medical emergency away from home, Seppi is grateful for how things turned out.
“I was so fortunate that all of this happened in Salt Lake City with the U of U Hospital right there, with a wonderful surgeon and a great team,” she said. “There were many other places it could have happened, and I might not have made it.”
Seppi, now 74 years old, continues to thrive. Since surgery, she has taken multiple trips to visit family across the United States and Europe, and even took some of her grandkids to London the summer after her surgery.
“I really can’t say enough about Dr. Johnson and her team,” she said.
Now, Dr. Johnson and her team are partnering with the FDA to help bring devices like this to the market. The University of Utah can now also create these custom devices in non-emergency situations to expand treatment to more people with aortic diseases.