Department of Legal Medicine, School of Medicine, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
Cardiovasc Pathol. 2010 Jul-Aug;19(4):248-51. doi: 10.1016/j.carpath.2009.02.002. Epub 2009 Apr 16.
We report an autopsy case of segmental arterial mediolysis (SAM) of various phases occurring in both the intracranial vertebral artery (IVA) and intra-abdominal arteries. The patient was a 70-year-old male found dead in his house. The cause of death was massive intra-abdominal hemorrhage owing to a ruptured right gastroepiploic artery. Histopathological examination revealed that there was a broad arterial dissection as long as 20 cm in the right gastroepiploic artery associated with SAM in the injurious phase. In addition, SAM in the reparative phase was observed as organized arterial dissections in the left gastric artery. Furthermore, SAM in the reparative phase was detected as an arterial dissection in the right IVA undergoing an organizing process. These three lesions were considered to have developed at different times. SAM occurring in both the intra-abdominal and intracranial vertebral arteries is extremely rare. This coincidence may provide a clue to the relationship between SAM and spontaneous IVA dissection.
我们报告了一例颅内椎动脉（IVAs）和腹内动脉各期节段性动脉中层溶解症（SAM）的尸检病例。患者为 70 岁男性，被发现在家中死亡。死亡原因是由于右胃网膜动脉破裂导致大量腹腔内出血。组织病理学检查显示，右胃网膜动脉有长达 20 厘米的广泛动脉夹层，伴有损伤期的 SAM。此外，左胃动脉中观察到修复期的 SAM 表现为有组织的动脉夹层。此外，修复期的 SAM 在正在进行组织过程的右 IVA 中被检测为动脉夹层。这三个病变被认为是在不同时间发生的。同时发生在腹内和颅内椎动脉的 SAM 极为罕见。这种巧合可能为 SAM 和自发性 IVA 夹层之间的关系提供线索。
