Spontaneous Isolated Superior Mesenteric Artery Dissection: A Case Report and Literature Review with Management Algorithm

Evolution of Computed Tomographic Characteristics of Spontaneous Isolated Superior Mesenteric Artery Dissection During Conservative Management

“…5 Moreover, arteriosclerosis, segmental arterial mediolysis, 6 fibroelastic disease, trauma, and other causes have been con-Spontaneous Isolated SMA Dissection…”

A Case Report of Aneuysmectomy after Thrombo-Intimectomy for Spontaneous Isolated Superior Mesenteric Artery Dissection

“…9) And some algorithms for management of SMA dissection are advocated. 2,4,6) Our patient belonged to type VIa and the CT revealed long segment obstruction at the onset.…”

“…2) Among such dissections, SMA dissection is the most frequent 1,2) and more frequently detected due to the increasing use of CT. 3) The pathogenesis of SMA dissection has been not resolved, but its relationship with hypertension, smoking, trauma, cystic medial necrosis, fibromuscular dysplasia, atherosclerosis, vasculitis, connective tissue disease and segmental mediolytic arteriopathy has been investigated. This patient smoked, and the histopathological findings suggested cystic medial necrosis of the SMA.…”

“…The natural course of SMA dissection would include limited progress with cessation, progressive involvement of the vessel, reestablishment of flow into the true lumen, or rupture through the adventitia. 2) Various treatments have been applied to SMA dissection. Therapeutic procedures include conservative, medical, endovascular and surgical treatments.…”

“…It is not easy to diagnose the bowel ischemia which needs revascularization. Subhas et al 2) advocated the management algorithm and recommended diagnostic laparoscopy. In a severe case, closed observation is necessary and intensive care including surgical treatment with lapatoromy should be considered without hesitation.…”