Isolated dissection of the superior mesenteric artery

Abstract

Dissection of the superior mesenteric artery (SMA) not associated with aortic dissection is rare. The purpose of this study is to describe the computed tomographic (CT) findings of this condition. We studied the CT findings of six patients with isolated dissection of the SMA. CT demonstrated thrombosis of the false lumen or intramural hematoma (n = 4) and/or intimal flap (n = 4) in all six patients. Other CT findings were enlarged diameter of the SMA (n = 5), increased attenuation of the fat around the SMA (n = 5), and hematoma in the mesentery with hemorrhagic ascites (n = 1). CT is useful for the diagnosis of isolated dissection of the SMA, and increased attenuation of the fat around the artery is considered the key to the diagnosis when no definite findings are evident.

Isolated dissection of the superior mesenteric artery: a case report and literature review

“…16 Recently, contrast-enhanced computed tomography (CT) has become the most reliable diagnostic modality; indeed, diagnosis in the acute stage has become possible as a result of advanced and increasing use of CT imaging techniques, 17 such as MDCT, leading to multiplanar reconstruction and reconstruction imaging, 18 and computed tomography angiography (CTA). [19][20][21][22][23] MDCT usually shows that the diameter of the SMA is enlarged and that there is increased attenuation of the fat surrounding the artery itself, together with images of true and false lumina, which can be identified by the presence of an intimal flap after the origin of the SMA (Table 2). In our case, MDCT provided enough information to diagnose spontaneous SMA dissection, and angiography was not necessary.…”

En mann i 70-årene med hypertensjon og akutte brystsmerter

“…Den ses bedre på CT-angiografi enn på kateterangiografi (4, 5), da sistnevnte ikke vil vise en eventuell totalt trombosert falsk lumen (5). På CT-angiografi kan man se økt diameter, intimalesjon, trombose av falsk lumen, intramuralt hematom eller økt fettinfiltrasjon i segmenter rundt arterien (5,8). Kateterangiografi vil allikevel vaere bedre enn CT-angiografi for demonstrering av dobbelt lumen og kollateral blodgjennomstrømming og vil derfor ha størst betyd-…”

Treatment of Spontaneous Superior Mesenteric Artery Dissection

“…SMA diseksiyonlarında yakın takip ve antikoagülasyonu içeren konservatif tedavi ile endovasküler ya da cerrahi revaskülarizasyonu içeren iki genel tedavi yöntemi vardır (1,2) .…”

“…SMA diseksiyonlarında yakın takip ve antikoagülasyonu içeren konservatif tedavi ile endovasküler ya da cerrahi revaskülarizasyonu içeren iki genel tedavi yöntemi vardır (1,2) .Rutin görüntüleme sırasında saptanan, semptomu olmayan olguların medikal izlemi yeterli olmaktayken, gerçek lümende belirgin obliterasyon yapmayan, kısa segment diseksiyonlar da antikoagülasyonu içeren konservatif tedavi ilk seçenek olarak yapılabilir (3) . Karın ağrısı yakınmasıyla daha sık abdominal bilgisayarlı tomografi (BT) kullanılması nedeniyle günü-müzde izole SMA diseksiyonlarıyla daha çok karşılaşılmaktadır.…”