Silent Superior Mesenteric Artery Dissection Discovered During Hypertensive Emergency With Acute Pulmonary Edema in...

Isolated superior mesenteric artery (SMA) dissection is a rare vascular condition that is increasingly recognized due to the widespread use of advanced imaging modalities. It may present with abdominal pain or remain asymptomatic and be detected incidentally. We report the case of a 62-year-old male with end-stage renal disease (ESRD) on hemodialysis who presented with hypertensive emergency and acute pulmonary edema, in whom SMA dissection was incidentally identified on computed tomography angiography (CTA). The patient was successfully managed conservatively with blood pressure control, antithrombotic therapy, and close monitoring. This case highlights the importance of individualized management strategies in asymptomatic SMA dissection and supports the role of conservative therapy in stable patients without evidence of bowel ischemia.