Acute mesenteric infarction is a rare but emergency disease with a high mortality rate. The rapidly restoration of intestinal blood flow is the early goal of vascular intervention. However, the unspecific presentation may confuse physicians and delay a timely diagnosis. The rate of intestinal failure in survivors is still high. Here, we present the case of an 85-year-old male presenting with acute onset progressive periumbilical cramping pain with elevated D-dimer. The abdominal computed tomography (CT) revealed severe acute superior mesenteric artery occlusion. The surgical report showed a massively ischemic small intestine that was about 250 cm with 200 mL bloody ascites. We highlight that early diagnosis and timely intervention are important for improving outcomes.

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Among young adults, a carotid artery dissection is one of the etiologies of morbidity. In the general population, the incidence of stroke due to dissection is around 2.5%, whereas a carotid dissection accounts for 19.5% of ischemic stroke in young adults. This could be due to injury or spontaneity, with the etiology controlled by several factors. A carotid artery dissection is a separation of arterial layers, which results in a tear in the arterial wall, causing invasion of blood into the wall of artery and leading to intra-luminal stenosis or aneurysmal dilatation. We describe a patient presented with claudication-like vision impairment. The image studies revealed spontaneous internal carotid artery dissection with severe occluded left internal carotid artery. With medical therapy with antiplatelets and anticoagulants, she was managed successfully with endovascular stenting with good neurological recovery to date. We also reviewed current reported studies of the dissection of the petrous portion of the internal carotid artery in Medline from 1960 to the present.