Document Type

Article

Version Deposited

Published Version

Publication Date

12-18-2024

Publication Title

J Surg Case Rep

DOI

10.1093/jscr/rjae789

Abstract

Isolated superior mesenteric dissection (ISMAD) is an uncommon condition, often diagnosed incidentally for presentations of acute abdominal pain. Early identification and treatment are crucial as complications such as bowel ischemia or vessel rupture can occur. There remain no established treatment guidelines, making surgical and endovascular indications controversial. A 60-year-old male presented with acute abdominal pain, and was diagnosed with ISMAD via computed tomography imaging. He was initially managed conservatively which progressed to worsening abdominal pain, hypertensive crisis, and hemoperitoneum on follow-up computed tomography angiography (CTA). A mesenteric angiogram revealed a pseudoaneurysm in the superior mesenteric artery (SMA) which was subsequently treated with coil embolization. The absence of long-term evidence on relapse rates questions the overall effectiveness of nonoperative therapy. Further research is needed to establish clear guidelines and to determine whether early intervention might be more advantageous in managing complications and preventing recurrence.

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Published Citation

Salma Emara, Madison Kropp, Masoud Akbari, Kristin Cook, A case of isolated SMA dissection with failed initial conservative management, Journal of Surgical Case Reports, Volume 2024, Issue 12, December 2024, rjae789, https://doi.org/10.1093/jscr/rjae789

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