Spontaneous Superior Mesenteric Artery (SMA) Dissection: An Unusual Cause of Abdominal Pain

Isolated Superior Mesenteric Artery Dissection with Small Intestine Ischemia

“…SMA dissection was reported in middle-aged men with hypertension and a smoking habit [ 3 ]. The presence of arteriosclerosis, fibromuscular dysplasia, and elastic tissue degeneration of the arterial wall were described as causes of SMA dissection by some investigators [ 4 ]. Enhanced CT is useful as initial imaging study for the patients presenting with severe abdominal pain since it can detect various pathological conditions including arterial dissection, although arteriography provides more specific information [ 4 ].…”

“…The presence of arteriosclerosis, fibromuscular dysplasia, and elastic tissue degeneration of the arterial wall were described as causes of SMA dissection by some investigators [ 4 ]. Enhanced CT is useful as initial imaging study for the patients presenting with severe abdominal pain since it can detect various pathological conditions including arterial dissection, although arteriography provides more specific information [ 4 ]. Various types of treatments such as conservative, endovascular, and surgical treatments have been reported with some success.…”

Three Cases of Spontaneous Isolated Dissection of the Superior Mesenteric Artery

“…Two of the patients in this report (Cases 2 and 3) were initially diagnosed with isolated SMA dissection by abdominal spiral contrast CT. The use of noncontrast CT can lead to a missed diagnosis of SMA dissection (11). Although contrast CT was initially performed, we could not establish a correct diagnosis in Case 1.…”

En mann i 70-årene med hypertensjon og akutte brystsmerter

“…Pasienter med a. mesenterica superiordisseksjon kan vaere asymptomatiske, men også oppleve akutte magesmerter lokalisert til epigastriet eller venstre flanke, med eller uten oppkast (6,15,16). Magesmertene kan komme av tarmiskemi, intraperitoneal blød-ning som skyldes ruptur av disseksjonen eller på grunn av inflammasjon rundt selve disseksjonen (5).…”

“…Hvis disseksjonen er trombosert og tromben(e) beveger seg distalt, kan de forårsake mesenteriell iskemi, noe som vil gi pasienten svaert sterke magesmerter, som i tillegg gjerne blir verre etter inntak av mat. Pankreatitt kan oppstå dersom disseksjonen sprer seg ut i forgreningen til pancreas (6).…”