Isolated Superior Mesenteric Artery Dissection with Small Intestine Ischemia

Area of Science:

• Vascular Surgery
• Gastroenterology
• Diagnostic Imaging

Background:

• Superior mesenteric artery (SMA) dissection, without concurrent aortic dissection, is an uncommon yet critical vascular emergency.
• Prompt diagnosis is challenging due to its rarity and nonspecific acute abdominal symptoms.

Observation:

• A 53-year-old male presented with sudden, severe abdominal pain.
• Diagnostic imaging, including enhanced CT, angiography, and intravascular ultrasound, confirmed an isolated SMA dissection.

Findings:

• Initial conservative management was initiated for the SMA dissection.
• Despite treatment, progressive ischemia necessitated partial small intestine resection.

Implications:

• This case highlights the importance of considering isolated SMA dissection in the differential diagnosis of acute abdominal pain.
• Increased awareness can lead to earlier detection and potentially improved patient outcomes, reducing the need for bowel resection.