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孤立性肠系膜上动脉夹层:绞痛性缺血的罕见病因。

Isolated Superior Mesenteric Artery Dissection: A Rare Etiology of Colic Ischemia.

作者信息

Ezeh Kosisochukwu J, Bellamy Shannay E

机构信息

Internal Medicine, Jersey City Medical Center, Jersey City, USA.

出版信息

Cureus. 2022 May 8;14(5):e24819. doi: 10.7759/cureus.24819. eCollection 2022 May.

Abstract

Although isolated superior mesenteric artery dissection is a rare disease entity, it possesses high mortality. The pathophysiology remains a mystery. In this case, we report a 68-year-old male with compromised coronary circulation been evaluated for coronary artery bypass surgery (CABG) and who developed a sudden, localized, right-sided abdominal pain. It was diagnosed on a computer tomography arteriogram (CTA), revealing a short segmental dissection involving the superior mesenteric artery (SMA). Vascular surgery was consulted and the decision was made to conservatively manage this patient's condition with anticoagulation. He was seen subsequently in the outpatient setting with a resolution of abdominal pain and a repeat computer tomography scan of the abdomen revealed resolution of previously seen colitis changes. Abdominal discomfort is a common complaint for which patients are seen in a variety of therapeutic settings, it is critical to bring attention to this case in order to raise awareness of the possibility of isolated SMA dissection as one of the underlying causes.

摘要

尽管孤立性肠系膜上动脉夹层是一种罕见的疾病,但死亡率很高。其病理生理学仍是个谜。在此病例中,我们报告一名68岁男性,因冠状动脉循环受损接受冠状动脉旁路移植术(CABG)评估,他突然出现局限性右侧腹痛。通过计算机断层扫描血管造影(CTA)确诊,显示肠系膜上动脉(SMA)有一小段节段性夹层。咨询了血管外科,决定采用抗凝保守治疗该患者的病情。随后在门诊复诊时,他腹痛消失,腹部计算机断层扫描复查显示先前的结肠炎改变已消失。腹部不适是患者在各种治疗环境中常见的主诉,提请注意此病例以提高对孤立性SMA夹层作为潜在病因之一的可能性的认识至关重要。

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