Isolated superior mesenteric artery dissection: CTA features and clinical relevance

Dou, Lei; Tang, Hao; Zheng, Ping; Wang, Chao; Li, Miaosi; Yang, Jun

doi:10.1007/s00261-019-02171-4

Cited by 16 publications

(12 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Acute mesenteric ischemia (AMI) accounts for 1-2% of acute abdominal emergencies. Similar to clinical findings in other types of acute mesenteric ischemia, SMA dissection causes severe and sudden onset abdominal pain with very few physical examination findings 6 . Spontaneous ISMAD represents 8% of all visceral artery dissections and has an overall prevalence of 0.09% in cadaveric studies 7 .…”

Section: Discussionsupporting

confidence: 57%

“…Connective tissue diseases and genetic susceptibility are also contributing factors to SMA dissection. Strong mechanical stress in the SMA wall is the main factor for SMA dissection 6 . However, no specific underlying cause of SMA dissection has been identified in the majority of reports 8 .…”

Section: Discussionmentioning

confidence: 99%

“…CT angiography can show false lumens and intimal flaps and is helpful in diagnosis. The size of the lesion and bowel infarction can also be detected by CT angiography 6 . Today catheter angiography remains the gold standard diag- nostic test for ISMAD.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A Rare Cause of Acute Abdomen in Emergency Room: Isolated Superior Mesenteric Artery Dissection

Güler

Bozan

Nida

et al. 2020

Journal of Emergency Medicine Case Reports

View full text Add to dashboard Cite

Introduction: Isolated superior mesenteric artery dissection (ISMAD) has severe and sudden-onset abdominal pain with little physical examination findings. Misdiagnosis of ISMAD is seen commonly in clinical practice, which may lead to severe intestinal ischemic necrosis or even death. Here, we present a patient with abdominal pain and diagnosed as ISMAD. Case Report: A 46-year-old male was admitted to the emergency department with sudden onset abdominal pain and constipation. He had hypertension and asthma in his history. There was epigastric tenderness in his physical examination. Laboratory tests revealed no pathological findings except high white blood cell count. His complaints did not alleviate despite medical treatment and contrast enhanced abdominal computed tomography was performed. The patient was diagnosed as ISMAD and underwent emergency surgery. The patient developed widespread bowel ischemic necrosis and exitus occurred. Conclusion: Emergency physicians should be aware of ISMAD and include this in differential diagnoses, especially in patients with acute onset of abdominal pain.

show abstract

Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Rare Cause of Acute Abdomen in Emergency Room: Isolated Superior Mesenteric Artery Dissection

Güler

Bozan

Nida

et al. 2020

Journal of Emergency Medicine Case Reports

View full text Add to dashboard Cite

show abstract

“…Original reports or reports from multi-center collaborations were included. Ninety-seven studies ( 1 …”

Section: Methodsmentioning

confidence: 99%

Management of Spontaneous Isolated Mesenteric Artery Dissection: A Systematic Review

Acosta

Gonçalves

2021

Scand J Surg

View full text Add to dashboard Cite

Background and Aims: There are increasing reports on case series on spontaneous isolated mesenteric artery dissection, that is, dissections of the superior mesenteric artery and celiac artery, mainly due to improved diagnostic capacity of high-resolution computed tomography angiography performed around the clock. A few case–control studies are now available, while randomized controlled trials are awaited. Material and Methods: The present systematic review based on 97 original studies offers a comprehensive overview on risk factors, management, conservative therapy, morphological modeling of dissection, and prognosis. Results and Conclusions: Male gender, hypertension, and smoking are risk factors for isolated mesenteric artery dissection, while the frequency of diabetes mellitus is reported to be low. Large aortomesenteric angle has also been considered to be a factor for superior mesenteric artery dissection. The overwhelming majority of patients can be conservatively treated without the need of endovascular or open operations. Conservative therapy consists of blood pressure lowering therapy, analgesics, and initial bowel rest, whereas there is no support for antithrombotic agents. Complete remodeling of the dissection after conservative therapy was found in 43% at mid-term follow-up. One absolute indication for surgery and endovascular stenting of the superior mesenteric artery is development of peritonitis due to bowel infarction, which occurs in 2.1% of superior mesenteric artery dissections and none in celiac artery dissections. The most documented end-organ infarction in celiac artery dissections is splenic infarctions, which occurs in 11.2%, and is a condition that should be treated conservatively. The frequency of ruptured pseudoaneurysm in the superior mesenteric artery and celiac artery dissection is very rare, 0.4%, and none of these patients were in shock at presentation. Endovascular therapy with covered stents should be considered in these patients.

show abstract

“…Populations typically affected include men with a history of atherosclerosis, hypertension, or tobacco use ( 5 ). Nevertheless, SMAD should prompt an assessment for arteriopathies, such as fibromuscular dysplasia or segmental arterial mediolysis, as well as interrogation of other arterial beds ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

Superior Mesenteric Artery Dissection

2021

View full text Add to dashboard Cite

Superior mesenteric artery dissection is a rare cause of acute abdomen. Potential etiologies include atherosclerosis, medial degeneration of the arterial wall, mycotic aneurysm, hypertension, and a variety of arteriopathies. Here, we present a case of superior mesenteric artery dissection prompting clinical genetic testing to investigate the underlying mechanisms of the vasculopathy. ( Level of Difficulty: Intermediate. )

show abstract

Isolated superior mesenteric artery dissection: CTA features and clinical relevance

Cited by 16 publications

References 18 publications

A Rare Cause of Acute Abdomen in Emergency Room: Isolated Superior Mesenteric Artery Dissection

A Rare Cause of Acute Abdomen in Emergency Room: Isolated Superior Mesenteric Artery Dissection

Management of Spontaneous Isolated Mesenteric Artery Dissection: A Systematic Review

Superior Mesenteric Artery Dissection

Contact Info

Product

Resources

About