Yu Zaiqiang, Kondo Norihiro, Chiyoya Mari, Suzuki Yasuyuki, Fukuda Ikuo
Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
Ann Vasc Dis. 2018 Mar 25;11(1):101-105. doi: 10.3400/avd.oa.17-00120.
: This study aimed to clarify the selection and determination of appropriate treatment for acute symptomatic spontaneous isolated dissection of the superior mesenteric artery (SIDSMA). : Data from 10 consecutive patients, who were diagnosed with symptomatic SIDSMA using computed tomography angiography and were managed in our hospital from January 2010 to October 2015, were retrospectively collected and analyzed. : There were nine males and one female; mean patient age was 50.3 (range, 35-64) years. All patients experienced acute abdominal pain, and three patients experienced concomitant vomiting. Only one patient exhibited symptoms of suspected peritonitis and intestinal ischemia. Three patients showed improved abdominal pain before admission to our hospital. One patient experienced severe abdominal pain that could not be managed using morphine; he underwent right external iliac to superior mesenteric artery bypass with a great saphenous vein graft. No patient presented with intestinal necrosis. All patients survived, and no patient developed complications during the follow-up period of up to 42 (24.5±16.5) months. : Conservative management appears to be the most feasible treatment for SIDSMA. However, open surgery can be performed in patients presenting with any symptoms of intestinal ischemia.
本研究旨在阐明急性症状性自发性孤立性肠系膜上动脉夹层（SIDSMA）合适治疗方法的选择与确定。回顾性收集并分析了2010年1月至2015年10月期间在我院接受治疗的10例连续患者的数据，这些患者通过计算机断层扫描血管造影被诊断为症状性SIDSMA。患者中男性9例，女性1例；平均年龄50.3岁（范围35 - 64岁）。所有患者均经历急性腹痛，3例患者伴有呕吐。仅1例患者出现疑似腹膜炎和肠缺血症状。3例患者在入院前腹痛有所改善。1例患者经历严重腹痛，吗啡治疗无效；他接受了右髂外动脉至肠系膜上动脉的大隐静脉移植搭桥手术。无患者出现肠坏死。所有患者均存活，在长达42（24.5±16.5）个月的随访期内无患者发生并发症。保守治疗似乎是SIDSMA最可行的治疗方法。然而，对于出现任何肠缺血症状的患者可进行开放手术。
