Pradhan Akshyaya, Bhandari Monika, Vishwakarma Pravesh, Kumar Shailendra, Rai Anurag
Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India.
Department of Thoracic and Vascular Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India.
Int J Angiol. 2021 Feb 3;30(4):313-316. doi: 10.1055/s-0040-1718544. eCollection 2021 Dec.
Isolated spontaneous dissection of the mesenteric artery in the absence of involvement of the aorta or its branches is an uncommon vascular entity. It is generally seen in males and presents with gastrointestinal symptoms due to mesenteric ischemia. However, asymptomatic cases are increasingly being diagnosed due to increased use of computed tomography (CT) angiography. The course is usually self-limiting, and conservative management with bowel rest, strict blood pressure control, anticoagulants, sedatives for pain, and close observation usually suffices. Surgery or endovascular stenting is usually reserved for those exhibiting bowel ischemia or impending rupture. We report a case of a young female with isolated spontaneous mesenteric artery dissection with thrombus, which did not improve with medical therapy and was managed promptly by surgery due to the presence of bowel ischemia.
孤立性肠系膜动脉自发夹层分离而不累及主动脉或其分支是一种罕见的血管疾病。该病多见于男性,因肠系膜缺血而出现胃肠道症状。然而,由于计算机断层扫描(CT)血管造影的使用增加,无症状病例的诊断也越来越多。病程通常为自限性,通过肠道休息、严格控制血压、使用抗凝剂、止痛镇静剂以及密切观察等保守治疗通常就足够了。手术或血管内支架置入通常仅用于那些出现肠缺血或即将破裂的患者。我们报告一例年轻女性孤立性自发肠系膜动脉夹层分离并伴有血栓形成的病例,该病例经药物治疗无改善,因存在肠缺血而迅速接受了手术治疗。