Acute penetrating atherosclerotic ulcer presenting as paraplegia and renal failure.

Acute aortic syndrome can present as aortic dissection, intramural hematoma or acute penetrating atherosclerotic ulcer (APAU). The clinical manifestations can be varied based on the etiology. APAU is defined as an acute ulceration of an atherosclerotic lesion that penetrates from the internal elastic lamina into the intima media. APAU was first described as a distinct clinical entity by Stanson et al. in 1986. The clinical behavior is controversial and advanced techniques of imaging have aided in the early detection of APAU. Here we are reporting a case of acute aortic syndrome diagnosed to have APAU, manifesting as paraplegia and acute renal failure.