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Multimodality Diagnosis of Mesenteric Ischemia
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Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

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Isolated Superior Mesenteric Artery Dissection: A Rare Etiology of Colic Ischemia

Kosisochukwu J Ezeh1, Shannay E Bellamy1

  • 1Internal Medicine, Jersey City Medical Center, Jersey City, USA.

Cureus
|June 10, 2022
PubMed

Insights

Isolated superior mesenteric artery dissection is a rare but deadly condition. This case highlights conservative management with anticoagulation as a successful treatment option for this rare vascular emergency.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Radiology

Background:

  • Superior mesenteric artery (SMA) dissection is a rare condition with high mortality.
  • The underlying pathophysiology of isolated SMA dissection remains poorly understood.
  • Prompt diagnosis and appropriate management are crucial for patient outcomes.

Observation:

  • A 68-year-old male with pre-existing coronary artery disease presented with acute right-sided abdominal pain.
  • Computed tomography arteriogram revealed a short segmental dissection of the SMA.
  • The patient had a history of evaluation for coronary artery bypass surgery (CABG).

Findings:

  • Conservative management with anticoagulation was initiated by the vascular surgery team.
  • The patient experienced resolution of abdominal pain following treatment.
  • Follow-up imaging demonstrated resolution of previously noted colitis changes.

Implications:

  • This case underscores the importance of considering isolated SMA dissection in patients with acute abdominal pain, even with concurrent cardiac conditions.
  • Conservative management may be a viable option for select patients with SMA dissection.
  • Increased awareness of this rare entity can improve diagnostic accuracy and patient management strategies.

Keywords:
acute abdomenanticoagulationcolic ischemiadissectionsmasuperior mesenteric arteryvascular

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