Basso Monique Camila, Flores Patrícia Carrasco, de Azevedo Marques Ary, de Souza Guilherme Leme, D'Elboux Guimarães Brescia Marília, Campos Cynthia Resende, de Cleva Roberto, Saldiva Paulo Hilario Nascimento, Mauad Thais
Department of Pathology, University of São Paulo Medical School, Brazil.
Pathol Int. 2005 Oct;55(10):632-8. doi: 10.1111/j.1440-1827.2005.01881.x.
Segmental arterial mediolysis (SAM) is a rare non-atherosclerotic non-inflammatory vascular disease that affects mainly muscular arteries of the splanchnic and cerebral territories. Reported herein are two cases of SAM in young women with fatal outcome. One of the patients had an atypical form of the disease, which primarily affected small intestinal submucosal and subserosal arteries, and resulted in acute mesenteric ischemia. The other had bilateral brain infarction with SAM of internal carotid arteries (ICA). Pathological examination of both cases did not reveal the cause of blood flow disturbance: large mesenteric branches of the former and ICA of the latter were free of either dissection or thrombosis; in addition, small intestinal arteries of the first patient did not show signs of vasculitis. These findings suggest that unusual pathways of arterial occlusion and dissection may occur in the context of SAM.
节段性动脉中层溶解（SAM）是一种罕见的非动脉粥样硬化性非炎性血管疾病，主要累及内脏和脑区的肌性动脉。本文报告了两例年轻女性发生的SAM，均导致死亡。其中一名患者患有非典型形式的该病，主要影响小肠黏膜下和浆膜下动脉，导致急性肠系膜缺血。另一名患者双侧脑梗死伴颈内动脉SAM。两例病例的病理检查均未发现血流紊乱的原因：前者的肠系膜大分支和后者的颈内动脉均无夹层或血栓形成；此外，首例患者的小肠动脉未显示血管炎迹象。这些发现表明，在SAM的情况下可能会出现动脉闭塞和夹层的异常途径。
