Sasaki Hideki, Sone Yoshiaki, Numata Yukihide, Kamiya Shinji, Asano Miki
Cardiovascular Surgery, Nagoya City University East Medical Center, Nagoya, JPN.
Cureus. 2023 Apr 25;15(4):e38100. doi: 10.7759/cureus.38100. eCollection 2023 Apr.
A 59-year-old male was transported to the emergency department by ambulance with complaints of left-sided abdominal pain. Blood gas analysis revealed elevated lactate, and plain computed tomography revealed no bowel ischemic change. Contrast-enhanced computed tomography revealed isolated superior mesenteric artery dissection with mildly stenosed true lumen. The patient was treated with conservative management on admission. Staged fluid intake, oral prescriptions, and diet were commenced with attention to the symptoms. After four days of hospitalization, the patient was discharged with a stable condition. However, the patient returned to our hospital complaining of left lower back pain three hours after discharge. Contrast-enhanced computed tomography revealed an enlarged false lumen with a moderately stenosed true lumen. After a thorough discussion between vascular surgeons and interventional radiologists, conservative management was commenced on the second admission. The clinical course was uneventful, with proof of improved imaging findings.
一名59岁男性因左侧腹痛由救护车送至急诊科。血气分析显示乳酸水平升高，普通计算机断层扫描未发现肠道缺血改变。增强计算机断层扫描显示孤立性肠系膜上动脉夹层，真腔轻度狭窄。患者入院后接受保守治疗。根据症状开始分阶段补液、口服给药和饮食调整。住院四天后，患者病情稳定出院。然而，患者出院三小时后因左下腹疼痛返回我院。增强计算机断层扫描显示假腔扩大，真腔中度狭窄。血管外科医生和介入放射科医生进行深入讨论后，患者第二次入院后开始保守治疗。临床过程平稳，影像学检查结果有所改善。
