Kratovska Aina, Ponomarjova Sanita, Ivanova Patricija, Ligers Arturs, Mohammadian Reza
Department of Interventional Radiology, Riga East University Hospital; Riga Stradins University, Department of Radiology, Latvia.
Department of Vascular Surgery and Interventional Radiology, Riga East University Hospital, Latvia.
Radiol Case Rep. 2023 Jun 27;18(9):3179-3183. doi: 10.1016/j.radcr.2023.06.027. eCollection 2023 Sep.
This case report describes the clinical presentation, diagnostic approach, and treatment strategies for a 58-year-old male patient diagnosed with spontaneous isolated superior mesenteric artery dissection (SISMAD). The patient presented with suddenonset abdominal pain and was diagnosed with SISMAD using computed tomography angiography (CTA). SISMAD is a rare but potentially serious condition that can lead to bowel ischemia and other complications. Management options include surgery, endovascular therapy and conservative management with anticoagulation and close observation. The patient was managed conservatively with antiplatelet therapy and close follow-up. During hospitalization, he received antiplatelet therapy and was closely monitored for signs of bowel ischemia or other complications. The patients' symptoms gradually improved over time, and he was eventually discharged on oral mono- antiagreggation therapy. Clinical follow-up showed a significant symptimatic improvement. Conservative management with antiplatelet therapy was chosen due to the absence of bowel ischemia signs and overall stable clinical condition of patient. This report emphasizes the importance of prompt recognition and management of SISMAD to prevent potentially life-threatening complications. Conservative management with antiplatelet therapy can be a safe and effective treatment option for SISMAD, especially in cases without evidence of bowel ischemia or other complications.
本病例报告描述了一名58岁男性患者的临床表现、诊断方法和治疗策略，该患者被诊断为自发性孤立性肠系膜上动脉夹层（SISMAD）。患者突发腹痛，通过计算机断层血管造影（CTA）被诊断为SISMAD。SISMAD是一种罕见但可能严重的疾病，可导致肠缺血和其他并发症。治疗选择包括手术、血管内治疗以及抗凝和密切观察的保守治疗。该患者接受了抗血小板治疗和密切随访的保守治疗。住院期间，他接受了抗血小板治疗，并密切监测肠缺血或其他并发症的迹象。随着时间的推移，患者的症状逐渐改善，最终出院并接受口服单一抗血小板聚集治疗。临床随访显示症状有显著改善。由于患者没有肠缺血迹象且临床状况总体稳定，因此选择了抗血小板治疗的保守治疗方法。本报告强调了及时识别和处理SISMAD以预防潜在危及生命并发症的重要性。抗血小板治疗的保守治疗对于SISMAD可能是一种安全有效的治疗选择，尤其是在没有肠缺血或其他并发症证据的情况下。
