目的探讨以腹泻为首发表现的主动脉夹层患者的临床特点。方法收集主动脉夹层患者353例,寻找以腹泻症状为首发表现的临床病例,分析其发病特点及临床转归。结果仅发现3例主动脉夹层以腹泻为首发表现,该3例患者以腹泻求治急诊科,均发生不同程度、不同时间的误诊,均在住院期间死亡。3例患者的死亡原因得到确诊,其中1例因主动脉造影确诊,1例因床边超声心动图确诊,1例因尸检确诊。结论以腹泻为首发表现的主动脉夹层主诉不典型,具有较高的误诊率及院内死亡风险,临床医师应具备较高的警惕性。 Objective To investigate the clinical features of patients with aortic dissection with diarrhea as the first manifestation. Methods A total of 353 patients with aortic dissection were enrolled in this study, looking for clinical cases with diarrhea symptoms as the first manifestation, and analyzing their onset characteristics and clinical outcomes. Results Only 3 cases of aortic dissection were found with diarrhea as the first manifestation. The 3 patients were treated with diarrhea for emergency department, all of them were misdiagnosed with different degrees and different times and died during hospitalization. Three patients were diagnosed of the cause of death, including one confirmed by aortic angiography, one confirmed by bedside echocardiography, and one confirmed by autopsy. Conclusions The main complaint of aortic dissection with diarrhea as the first manifestation is not typical, with high misdiagnosis rate and risk of nosocomial death. Clinicians should have high vigilance.