• Dong-Na Gao, Qing-Hui Qi, and Ping Gong.
• aEmergency Department bDepartment of Abdominal Emergency, the First Affiliated Hospital of Dalian Medical University, Dalian, China.
• Medicine (Baltimore). 2017 Nov 1; 96 (46): e8598e8598.

RationaleSpontaneous 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 ConcernsA 58-year-old male patient visited our emergency room with sudden onset of moderate-severe epigastric abdominal pain of uncertain cause.DiagnosesComputed 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.InterventionsConservative 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.OutcomesThe abdominal pain was relieved. Six months later, a follow-up of computed tomography angiography showed that the stent placed had no interval narrowing.LessonsBased 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.

23 keywords...

hide…