Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Nov;96(46):e8598.
doi: 10.1097/MD.0000000000008598.

Endovascular stenting of spontaneous isolated dissection of the superior mesenteric artery: A case report and literature review

Dong-Na Gao  1 , Qing-Hui Qi, Ping Gong
Affiliations
Review

Endovascular stenting of spontaneous isolated dissection of the superior mesenteric artery: A case report and literature review

Dong-Na Gao et al. Medicine (Baltimore). 2017 Nov.

Abstract

Rationale: Spontaneous isolated dissection of the superior mesenteric artery (SID-SMA) is a rare arterial disease that is difficult to differentiate from other diseases because of lack of specific clinical manifestation and for which there is no available optimal management strategy.

Patient concerns: A 58-year-old male patient visited our emergency room with sudden onset of moderate-severe epigastric abdominal pain of uncertain cause.

Diagnoses: Computed tomography scanning showed a characteristic "double lumen sign" of the superior mesenteric artery, and further computed tomography angiography findings revealed a dissected segment of the superior mesenteric artery.

Interventions: Conservative management was administered for 5 days, but the abdominal pain remained. Subsequently, an endovascular stent was placed in the affected superior mesenteric artery. Postoperative antiplatelet therapy was administered for 6 months.

Outcomes: The abdominal pain was relieved. Six months later, a follow-up of computed tomography angiography showed that the stent placed had no interval narrowing.

Lessons: Based on our review and the illustration of this case, endovascular stenting may be a preferred rescue treatment in SID-SMA patients for whom initial conservative treatment fails.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Diagnosis of spontaneous isolated dissection of the superior mesenteric artery. The characteristic finding of a “double lumen sign” of the superior mesenteric artery was found on axial views of computed tomography images (A), and a dissected segment of superior mesenteric artery was found on computed tomography angiography (B) and selective mesenteric angiography (C).
Figure 2
Figure 2
Computed tomography angiogram showing patency of the stent (arrow) 6 months postoperatively.
Figure 3
Figure 3
Angiographic classification of spontaneous isolated dissection of the superior mesenteric artery. Reproduced from Yun et al.[10]
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Kim YW. Current understandings of spontaneous isolated superior mesenteric artery dissection. Vasc Specialist Int 2016;32:37–43. - PMC - PubMed
    1. Kim HK, Jung HK, Cho J, et al. Clinical and radiologic course of symptomatic spontaneous isolated dissection of the superior mesenteric artery treated with conservative management. J Vasc Surg 2014;59:465–72. - PubMed
    1. Cho YP, Ko GY, Kim HK, et al. Conservative management of symptomatic spontaneous isolated dissection of the superior mesenteric artery. Br J Surg 2009;96:720–3. - PubMed
    1. Funahashi H, Shinagawa N, Saitoh T, et al. Conservative treatment for isolated dissection of the superior mesenteric artery: Report of two cases. Int J Surg Case Rep 2016;26:17–20. - PMC - PubMed
    1. Heo SH, Kim YW, Woo SY, et al. Treatment strategy based on the natural course for patients with spontaneous isolated superior mesenteric artery dissection. J Vasc Surg 2017;65:1142–51. - PubMed

MeSH terms