Recanalization of Iatrogenic Dissection of the Superior Mesenteric Artery

Saguchi, Toru; Saito, Kazuhiro; Koizumi, Kiyoshi; Katakami, Toshio; Miyaoka, Masaaki; Akata, Soichi; Tokuuye, Koichi

doi:10.1177/1538574413485647

Cited by 2 publications

(2 citation statements)

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“…This suggests that SMA dissection can have a subacute or chronic course and physicians should have a high index of suspicion in an appropriate setting. Seven patients or 4.8% had SMA dissection discovered either on autopsy or as an incidental finding on CT scan performed for pancreatitis or other reasons 27)29)30)31)…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Isolated Superior Mesenteric Artery Dissection: A Systematic Review and Meta-Analysis

et al. 2019

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The objective of this study was to analyze the three different management modalities for isolated superior mesenteric artery (SMA) dissection. We did a comprehensive literature search and found 703 articles on the initial search, out of which 111 articles consisting of 145 patients were selected for analysis. The mean age was 55.7 years (standard deviation,9.7;33–85) and 80.6% were male. These patients were managed conservatively (41.3%), endovascularly (28.1%) or surgically (30%). The median follow-up was 10 months (interquartile range [IQR], 4–18 months), 12 months (IQR, 6–19 months) and 14 months (IQR, 6–20 months) respectively. Contrast-enhanced computed tomography (CT) was the most commonly used diagnostic tool in the conservative group (43.8%), while conventional CT scan was the most widely used in endovascular (58.1%) and surgical group (50%). 17% percent of the conservative group had SMA angiography for diagnosis, while this was less than 3% in the other groups. Of these patients, 96.7%, 97.4%, and 100.0% recovered successfully in the conservative, endovascular, and surgical groups respectively. There was no significant difference in the mortality between the three groups (Pearson χ 2 =0.482). This suggests a conservative and endovascular approach could be used in most patients, which can reduce costs and surgery-related morbidity and mortality. Surgical management should be reserved for cases having infarction or widespread bowel ischemia and in cases where other treatment modalities fail.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Isolated Superior Mesenteric Artery Dissection: A Systematic Review and Meta-Analysis

et al. 2019

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“…Commonly known as the artery of the midgut, the SMA sends nearly 15-18 branches, irrigating two out of three portions of the transverse colon and other organs from the abdominal cavity [7]. The pathway goes downwards and to the back of the splenic vein and the thin section of the pancreas.…”

Section: Discussionmentioning

confidence: 99%

Superior Mesenteric Artery Dissection After Lumbar Puncture

Ramirez

Casillas²,

Berjaoui

et al. 2020

Cureus

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We hereby present a case of iatrogenic dissection of the superior mesenteric artery dissection in a 63-year-old female undergoing a lumbar puncture (LP). She presented with severe diffused abdominal pain accompanied by lower back pain, nausea and vomiting a few hours after undergoing an LP due to ongoing headaches. Abdominal CT showed evidence of hemoperitoneum. She was then transferred to another facility and while in route received one unit of packed red blood cellsdue to drop in hemoglobin levels from 15 to 11 gm/dl. Physicians should consider the possibility of arterial variations and the level at which spinal tap is performed during interventions. Acute abdominal pain is a significant, common complaint that should be appropriately investigated.

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Recanalization of Iatrogenic Dissection of the Superior Mesenteric Artery

Cited by 2 publications

References 9 publications

Diagnosis and Management of Isolated Superior Mesenteric Artery Dissection: A Systematic Review and Meta-Analysis

Diagnosis and Management of Isolated Superior Mesenteric Artery Dissection: A Systematic Review and Meta-Analysis

Superior Mesenteric Artery Dissection After Lumbar Puncture

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