Human Adult Stem Cells Restore Endothelial Migratory Dysfunction in a Hypoxic Environment

Abstract

Background: Spontaneous dissection of the superior mesenteric artery (SMA) is rare. We report a case of rupture of the SMA after spontaneous dissection in a 51-year-old man who presented with acute onset of abdominal pain and hypotension. The patient was diagnosed as having segmental arterial mediolysis (SAM).Case: The patient was initially treated with intravenous fluid resuscitation and endovascular intervention, followed by open surgery. The relevant features of the case as well as SAM are presented. In addition, a review of all available published literature on SAM to date is presented. No identifiable cause for dissection was found. The patient was diagnosed as having SAM. He did well and was discharged home on postoperative day 8. A follow-up CT scan showed additional disease characteristic of SAM in a branch of the inferior mesenteric artery that was treated with coil embolization.Conclusions: SAM is a rare arteriopathy of unknown etiology. Differential diagnosis includes fibromuscular dysplasia and inflammatory arteritis such as polyarteritis nodosa. Differentiation is important, because there is no standard treatment for SAM.