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孤立性肠系膜上动脉夹层:腹痛的一种罕见病因。

Isolated Superior Mesenteric Artery Dissection, A Rare Cause Of Abdominal Pain.

机构信息

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.

出版信息

Port J Card Thorac Vasc Surg. 2023 Jan 14;29(4):73. doi: 10.48729/pjctvs.297.

Abstract

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.

摘要

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。

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