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Updated: Jun 11, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Isolated superior mesenteric artery dissection
1Department of Radiology, Focus Diagnostic Center, Punjagutta, Hyderabad, India.
Abstract:
Isolated superior mesenteric artery (SMA) dissection without involvement of the aorta and the SMA origin is unusual. We present a case of an elderly gentleman who had chronic abdominal pain, worse after meals. CT angiography, performed on a 64-slice CT scanner, revealed SMA dissection with a thrombus. A large artery of Drummond was also seen. The patient was managed conservatively.
Insights
Isolated superior mesenteric artery (SMA) dissection is rare. This case highlights conservative management for SMA dissection presenting with chronic abdominal pain in an elderly patient.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Gastroenterology
Background:
- Superior mesenteric artery (SMA) dissection, particularly isolated forms, is an uncommon vascular emergency.
- Chronic abdominal pain, especially postprandial, can be a presenting symptom of mesenteric ischemia.
Observation:
- An elderly male presented with chronic, postprandial abdominal pain.
- CT angiography revealed an isolated superior mesenteric artery (SMA) dissection with an associated thrombus.
- A prominent artery of Drummond was noted during imaging.
Findings:
- The imaging findings confirmed an isolated SMA dissection, excluding aortic or proximal SMA origin involvement.
- The presence of a thrombus within the dissected SMA lumen was identified.
- Conservative management was chosen for this patient.
Implications:
- This case underscores the importance of considering SMA dissection in the differential diagnosis of chronic abdominal pain.
- Conservative management may be a viable option for select cases of isolated SMA dissection.
- Further research into optimal management strategies for isolated SMA dissection is warranted.