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Segmental Arterial Mediolysis: An Under-Recognized Cause of Chronic Abdominal Pain

Tulika Chatterjee1, Johnathon Stephens2, Moni Roy1,3

  • 1Department of Internal Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA.

European Journal of Case Reports in Internal Medicine
|October 21, 2020
PubMed

Insights

Segmental arterial mediolysis (SAM) is an underdiagnosed cause of abdominal pain. This case highlights that conservative management can lead to clinical improvement in patients with SAM.

Area of Science:

  • Vascular Medicine
  • Gastroenterology

Background:

  • Segmental arterial mediolysis (SAM) is a non-inflammatory vasculopathy affecting abdominal arteries.
  • It is an increasingly recognized cause of abdominal pain, often missed in emergency room settings.
  • Previous reports focused on severe complications like intra-abdominal hemorrhage.

Purpose of the Study:

  • To increase awareness of SAM as a cause of chronic abdominal pain in middle-aged and elderly individuals.
  • To guide differentiation of SAM from inflammatory vasculitis and atherosclerosis.
  • To outline conservative management strategies for stable SAM cases.

Main Methods:

  • Case report detailing a missed diagnosis of SAM.
  • Review of clinical presentation and diagnostic challenges.
  • Description of conservative management and patient outcome.

Main Results:

  • The case illustrates a missed diagnosis of SAM.
  • Conservative medical management resulted in clinical improvement.
  • Highlights the importance of considering SAM in unexplained abdominal pain.

Conclusions:

  • SAM should be recognized as a potential cause of chronic abdominal pain.
  • Differentiating SAM from other vasculopathies is crucial for appropriate management.
  • Conservative treatment, including lifestyle changes and risk factor control, is effective for stable SAM.
Keywords:
Segmental arterial mediolysischronic abdominal pain

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