Serviço de Angiologia e Cirurgia Vascular, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Portugal.
Serviço de Angiologia e Cirurgia Vascular, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Portugal; NOVA Medical School, Universidade NOVA de Lisboa, Portugal.
Port J Card Thorac Vasc Surg. 2023 Jan 14;29(4):73. doi: 10.48729/pjctvs.297.
A 42-year-old previously healthy male presented with 5 days of spontaneous mid-epigastric intense abdominal pain and mild epigastric tenderness on palpation. CT angiography revealed a Sakamoto type 2 isolated superior mesenteric artery dissection (SMA) with a "cul-de-sac" shaped false lumen (B- C: large arrow), side branch perfusion from both lumens, and compression of the true (A-D: small arrow) by the false lumen (A-D: large arrow). Dissection flap presented just distal to an aberrant right hepatic artery arising from the SMA (B.D: star). CT, clinical and analytic findings did not suggest visceral compromise and was successfully treated with bowel rest and anticoagulation. He is now on close clinical and imaging follow-up.
一位 42 岁既往健康的男性因自发性中上腹痛 5 天就诊，触诊时上腹部轻度压痛。CT 血管造影显示 Sakamoto 2 型孤立性肠系膜上动脉夹层（SMA），伴有“袋状”假腔（B-C：大箭头），双腔侧支灌注，真腔受压（A-D：小箭头）由假腔（A-D：大箭头）。夹层瓣位于起源于 SMA 的异常右肝动脉远端（B.D：星号）。CT、临床和分析结果未提示内脏受累，采用肠休息和抗凝治疗获得成功。目前他正在密切进行临床和影像学随访。
