Isolated Superior Mesenteric Artery Dissection: An Unusual Etiology of Epigastric Pain

Abstract

Abdominal pain is a very common presentation in the emergency department (ED). The pain is often wellcharacterized and leads to the diagnosis, but often, the presentation is vague and nonspecific. Superior mesenteric artery (SMA) dissection is a rare cause of abdominal pain that presents with nonspecific epigastric pain and is common in males, middle age, and patients of Asian descent. A high index of suspicion is usually helpful with imaging modalities such as computer tomography (CT) scan and ultrasonography in experienced hands. A prompt diagnosis is vital to managing this disease which may range from non-surgical intervention with supportive therapy to invasive endovascular procedures and surgery. Here, we report a case of an isolated SMA dissection presenting with vague abdominal symptoms and highlight the need to explore the vascular etiology of abdominal pain as their diagnosis is often difficult and may result in irreversible bowel injury when missed.

Features of Surgical Treatment of Symptomatic Patients with Isolated Superior Mesenteric Artery Dissection (Clinical Cases and Literature Review)

“…Для підтвердження діагнозу ІРВБА найчастіше використовують МСКТ-ангіографію, яка є «золотим стандартом» діагностики гострої ішемії кишківника [11,12]. Інші методи діагностики включають: ультразвукове дуплексне сканування, магнітно-резонансну томографію та субтракційну ангіографію [13,14].…”