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Updated: Jun 14, 2026

Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
[Segmental mediolytic arteriopathy (SMA) of central, visceral and peripheral vessels]
E Schönefeld1, W Völker, G Torsello
1CVEC Centrum für Vaskuläre und Endovaskuläre Chirurgie, Westfälische Wilhelms-Universität Münster und Abteilung für Gefässchirurgie des St-Franziskushospitals Münster, Münster. Eva.Schoenefeld@ukmuenster.de
History And Clinical Findings:
A 27-year-old man had been admitted to hospital with acute neurological defects involving his legs and urinary system. An intervertebral disk was removed surgically, because a herniation had been suspected. But symptoms increased postoperatively. Further imaging showed a ruptured aneurysm of the internal iliac artery which was treated with coil embolization.
Investigations:
Further diagnostic tests excluded hematological, rheumatic and endocrinological causes for the development of the aneurysm. Genetic differentiation was normal. Imaging then demonstrated "string of beads" small aneurysms of intra- and extracerebral, renal, visceral and peripheral arteries.
Treatment And Course:
During the past three years the patient had repeated ruptures of the intra-abdominal arterial aneurysms for which coil embolization and bypass grafting were performed, also to prevent further ruptures.
Conclusions:
Segmental mediolytic arteriopathy is a rare condition requiring careful imaging and histological tests for its diagnosis and acute surgical treatment.
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