scholarly journals Clinical features of isolated superior mesenteric artery dissection in the emergency department: a single center retrospective study

2021 ◽  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Liver Function ◽  
Mesenteric Artery ◽  
Artery Dissection ◽  
Test Results ◽  
Laboratory Test Results ◽  
History Of ◽  
Superior Mesenteric Artery Dissection ◽  
D Dimer

Isolated superior mesenteric artery dissection (ISMAD) is a relatively rare disease and often lacks specificity in its clinical presentation, diagnosing it in emergency departments quickly and accurately is a challenge. The study was conducted to understand the basic characteristics of ISMAD including age of onset, risk factors, gender difference and whether D-dimer can be used as a biomarker for its detection. We retrospectively analyzed patients with ISMAD admitted to the emergency department of Xiangya Hospital of Central South University from September 1, 2017 to September 30, 2020. The data included the patient’s basic information and the first laboratory test results after admission, including routine blood, liver function, renal function and coagulation function tests. Statistical analysis of results was done using GraphPad Prism 5. There were a total of 17 (15 male and 2 female) patients with a mean age of 52.53 ± 7.11 years diagnosed with ISMAD. Out of these, 7 (41%) patients had history of hypertension, 7 (41%) had history of smoking and/or alcohol intake, and almost all patients experienced significant abdominal pain and fullness. Four patients (24%) were initially misdiagnosed. The laboratory test results of renal, liver function tests and myocardial enzymology were in their normal ranges. In coagulation results, the positive rates of fibrinogen degradation products (FDP) and D-dimer were 29% and 35%, respectively. We compared these ISMAD results with our previous results for acute aortic dissection (AAD). D-dimer and FDP levels were lower in the ISMAD than in the AAD patients (P = 0.0004, P = 0.0325, respectively), and negative rates of D-dimer and FDP in ISMAD (65%, 71%) were higher than in AAD patients (14%, 24%) (P < 0.0001, P = 0.0003, respectively). In our study, ISMAD mostly occurred in middle-aged male patients with known hypertension or active smoking status. Misdiagnosis was common (24% of cases). Since D-dimer and FDP levels proved to be of limited diagnostic value, an abdominal Computed Tomography (CT) scan should be conducted in patients with unclear abdominal pain at an early stage of their diagnostic workup.

scholarly journals Spontaneous Renal Artery Dissection in a Man with Previous Spontaneous Superior Mesenteric Artery Dissection

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Yujiro Yokoyama ◽  
Masato Nakajima
Keyword(s):  
Renal Artery ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Rare Case ◽  
Visceral Artery ◽  
Artery Dissection ◽  
History Of ◽  
Natural Histories ◽  
Superior Mesenteric Artery Dissection ◽  
Device Technology

Both spontaneous superior mesenteric artery dissection (SMAD) and spontaneous renal artery dissection (SRAD) are very rare conditions. Their etiologies and natural histories are not precisely defined, but they are thought to be associated with underlying conditions. In this report, we describe an extremely rare case of SRAD in a man who had a history of spontaneous SMAD. We successfully treated SRAD with endovascular intervention. Isolated spontaneous SMAD and SRAD are both rare conditions. Their optimal treatment has not been established due to their rare entities, but endovascular treatment is a good option because it can prevent both advancement of infarction and renovascular hypertension, and it has become safer as device technology has improved. Patients with isolated visceral artery dissection should be carefully followed up.

Acute Abdominal Pain: Mind the Superior Mesenteric Artery Dissection

2015 ◽  
Vol 49 (5) ◽  
pp. e155-e157 ◽  
Author(s):  
Nicolas de l'Escalopier ◽  
Guillaume Boddaert ◽  
Thomas Erauso ◽  
Emmanuel Hornez
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Acute Abdominal Pain ◽  
Artery Dissection ◽  
Superior Mesenteric Artery Dissection

scholarly journals New technique for false lumen coiling of spontaneous isolated superior mesenteric artery dissection

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Hidenori Yamaguchi ◽  
Satoru Murata ◽  
Tatsuo Ueda ◽  
Takahiko Mine ◽  
Shiro Onozawa ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
False Lumen ◽  
Endovascular Intervention ◽  
Visceral Artery ◽  
Artery Dissection ◽  
Persistent Symptoms ◽  
Catheter Technique ◽  
Superior Mesenteric Artery Dissection

Abstract Background Spontaneous isolated visceral artery dissection is rarely encountered. Endovascular intervention with good outcomes has become popular for patients with persistent symptoms or developing ischemia. We could perform life-saving treatment for a spontaneous isolated superior mesenteric artery dissection with a unique endovascular intervention. Case presentation We describe the case of an 80-year-old man who presented with acute abdominal pain and a spontaneous isolated superior mesenteric artery dissection measuring 35 mm in major diameter and 6.6 mm in minor diameter on abdominal contrast-enhanced computed tomography. After admission, abdominal pain was progressive, and a repeated scan revealed progression of the dissection. As an endovascular intervention, via the bilateral femoral approach, detachable coils were placed in the false lumen of the superior mesenteric artery dissection through the false lumen under the micro-balloon occlusion at the point of re-entry and entry through the true lumen to prevent coil migration. Technical and clinical success was achieved without serious adverse events. Conclusion Coil embolization using micro-balloon assistance combined with the double-catheter technique for a large entry and re-entry false lumen of a spontaneous isolated superior mesenteric artery dissection was useful and feasible.

scholarly journals Abdominal pain at complicated spontaneous superior mesenteric artery dissection

Angiología ◽  
2021 ◽  
Author(s):  
Inés Cañas García ◽  
Julio Santoyo Villalba ◽  
Rafael Ros Vidal ◽  
Benito Mirón Pozo ◽  
Luis Miguel Salmerón Febres
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Artery Dissection ◽  
Superior Mesenteric Artery Dissection

scholarly journals Superior Mesenteric Artery Dissection after Extracorporeal Shockwave Lithotripsy

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Christos Bakoyiannis ◽  
Ioannis Anastasiou ◽  
Andreas Koutsoumpelis ◽  
Evangelos Fragiadis ◽  
Eleni Felesaki ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Extracorporeal Shockwave Lithotripsy ◽  
Artery Dissection ◽  
Shockwave Lithotripsy ◽  
Extracorporeal Shockwave ◽  
Patient’S History ◽  
Superior Mesenteric Artery Dissection

The use of shockwave lithotripsy is currently the mainstay of treatment in renal calculosis. Several complications including vessel injuries have been implied to extracorporeal shockwave lithotripsy. We report an isolated dissection of the superior mesenteric artery in a 60-year-old male presenting with abdominal pain which occurred three days after extracorporeal shockwave lithotripsy. The patient was treated conservatively and the abdominal pain subsided 24 hours later. The patient's history, the course of his disease, and the timing may suggest a correlation between the dissection and the ESWL.

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