+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Management of spontaneous isolated dissection of the superior mesenteric artery: Case report and literature review



Management of spontaneous isolated dissection of the superior mesenteric artery: Case report and literature review



World Journal of Emergency Surgery 6: 16



The aim of this study was to assess retrospectively the clinical presentation, management and outcome of three patients with isolated SMA dissection encountered at Okinawa Prefectural Chubu Hospital, Japan from 2005 to 2006, along with a review of the literature. We follow up the patient's clinical symptoms and the image by using enhanced dynamic CT at 1 week, 1 or 2 months, 6 months, and yearly after onset. We present three patients with acute abdominal pain due to spontaneous dissection of the superior mesenteric artery (SMA), who were treated by surgical revascularization or conservative management. Two patients underwent surgery because of signs or symptoms of intestinal ischemia and one patient elected conservative management. The SMA was repaired by bypass graft in two cases, and in one of these, the graft was occluded because of prominent native flow from the SMA. All patients were symptom free and there was no evidence of disease recurrence after a median follow-up of 4.3 years. Although the indications for surgery are still controversial, we should proceed with exploratory laparotomy if the patient has acute symptoms with suspicion of mesenteric ischemia. A non-operative approach for SMA dissection requires close follow-up abdominal CT, with a focus on the clinical signs of mesenteric ischemia and the vascular supply of the SMA, including collateral flow from the celiac artery and inferior mesenteric artery.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 054246708

Download citation: RISBibTeXText

PMID: 21549001

DOI: 10.1186/1749-7922-6-16


Related references

Spontaneous isolated superior mesenteric artery dissection: a case report and literature review with management algorithm. Annals of Vascular Surgery 23(6): 788-798, 2010

Isolated, spontaneous superior mesenteric and celiac artery dissection: case report and review of literature. Journal of Emergency Medicine 40(2): E21-E25, 2011

Endovascular management for isolated spontaneous dissection of the superior mesenteric artery: report of two cases and literature review. Journal of Vascular and Interventional Radiology 22(8): 1206-1211, 2011

Endovascular stenting of spontaneous isolated dissection of the superior mesenteric artery: A case report and literature review. Medicine 96(46): E8598, 2017

Nonoperative management of isolated celiac and superior mesenteric artery dissection: case report and review of the literature. Vascular 17(6): 359-364, 2010

Nonoperative Management of Isolated Celiac and Superior Mesenteric Artery Dissection: Case Report and Review of the Literature. Vascular 17(6): 359-364, 2009

Isolated Superior Mesenteric Artery Dissection: A Case Report and Literature Review. Gastroenterology Research 11(5): 374-378, 2018

Percutaneous endovascular treatment for isolated spontaneous superior mesenteric artery dissection: report of two cases and literature review. Catheterization and Cardiovascular Interventions 73(2): 145-151, 2009

Three Case Report of Spontaneous Isolated Dissection of the Superior Mesenteric Artery-With an Algorithm Proposed for the Management. Annals of Vascular Diseases 8(2): 120-123, 2015

Transient ischemic jejunitis due to symptomatic isolated superior mesenteric artery dissection: case report and review of literature. Clujul Medical 90(1): 107-111, 2017

Isolated spontaneous dissection of the superior mesenteric artery: a case report. Annales de Cardiologie et d'Angeiologie 57(4): 238-242, 2008

Treatment results for spontaneous isolated superior mesenteric artery dissection according to our previous guidelines and collective literature review. Annals of Vascular Surgery 28(7): 1595-1601, 2014

Spontaneous superior mesenteric artery dissection: report of 2 patients and review of management recommendations. Vascular and Endovascular Surgery 45(3): 295-298, 2011

Spontaneous isolated dissection of the superior mesenteric artery: an uncommon cause of acute abdomen. A case report. La Revue de Medecine Interne 36(2): 131-134, 2015

A case report of aneuysmectomy after thrombo-intimectomy for spontaneous isolated superior mesenteric artery dissection. Annals of Vascular Diseases 5(2): 204-207, 2012