Spontaneous dissection of the superior mesenteric artery

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Gastroenterology

Background:

• Spontaneous dissection and thrombosis of the superior mesenteric artery (SMA) is a rare but serious vascular emergency.
• It can present with acute abdominal pain and new-onset hypertension.

Observation:

• A 54-year-old male presented with epigastric pain and newly diagnosed hypertension.
• Initial treatment with catheter-directed thrombolysis was unsuccessful.

Findings:

• The patient underwent surgical intervention for SMA dissection and thrombosis.
• Extensive intimectomy was performed, creating a prothrombotic surface and compromising outflow.

Implications:

• Early initiation of antiplatelet therapy or anticoagulation is crucial after extensive intimectomy.
• This management strategy aims to preserve vessel patency and prevent re-thrombosis.
• This case highlights the importance of aggressive medical management post-surgery for SMA dissection.