Intra-abdominal Hemorrhage Caused by Segmental Arterial Mediolysis of the Inferior Mesenteric Artery: Report of a Case

Abstract

This is the first known reported case of intra-abdominal hemorrhage related to segmental arterial mediolysis requiring emergent hemicolectomy.

A case report of segmental arterial mediolysis in which computed tomography angiography was useful for diagnosis

“…However, there is no consensus on a definitive therapy because the long-term natural history of SAM is yet to be defined. Moreover, Oya et al [17] reported a case of aneurysm re-rupture caused by SAM, and another author reports that mortality in the acute phase of this disease is close to 50 % [6]. Therefore, we believed that our patient required appropriate treatment.…”

“…Treatment options include conservative care, surgical intervention, and/or endovascular therapy [4, 5]. However, the incidence and mortality of SAM is difficult to accurately estimate because of the rare nature of the disease [6], and optimal therapy for SAM has not been established. Although histopathological examination is the gold standard for diagnosis, patients do not always undergo surgery.…”

Dieulafoy's lesion with intra-abdominal haemorrhage: a novel association

“…The two main causes include blunt trauma and benign gynaecological disease, while the less frequent aetiologies include neoplastic, inflammatory and vascular lesions 3. Common vascular disorders include variceal rupture in patients with portal hypertension, inflammatory vasculitis such as polyarteritis nodosa and rupture of aortic or mesenteric aneurysms 4. Dieulafoy’s lesion is a kind of vascular malformation, which although fairly uncommon is a clinically significant cause of upper gastrointestinal haemorrhages.…”

Successful treatment tailored to each splanchnic arterial lesion due to segmental arterial mediolysis (SAM): Report of a case

“…The angiographic findings of SAM are irregularity of the vascular wall, widening and narrowing of a vessel (string of beads appearance), an occlusion or interruption, and dissection or aneurysmal enlargement. 2,[8][9][10] In addition, a hematoma around affected vessels is often shown on CT (much more easily visible on MDCT). 11 However, those findings seen in SAM are often similar to those of vasculitis such as polyarteritis nodosa, fibromuscular dysplasia, and pseudoaneurysms, making its differential diagnosis much more difficult.…”