Conservative management of symptomatic spontaneous isolated dissection of the superior mesenteric artery

Background: Spontaneous isolated dissection of the superior mesenteric artery (SMA) is uncommon. Because of its rarity, the risk factors, aetiology and natural history are unclear, and there is no consensus on the optimal treatment strategy. Methods: Seven consecutive patients with symptomatic spont...

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Bibliographic Details
Published in:British journal of surgery 2009-07, Vol.96 (7), p.720-723
Main Authors: Cho, Y. P., Ko, G. Y., Kim, H. K., Moon, K. M., Kwon, T. W.
Format: Article
Language:English
Subjects:
Abdominal Pain - etiology
Adult
Anticoagulants - therapeutic use
Biological and medical sciences
Female
General aspects
Humans
Male
Medical sciences
Mesenteric Artery, Superior - diagnostic imaging
Mesenteric Vascular Occlusion - diagnostic imaging
Mesenteric Vascular Occlusion - drug therapy
Middle Aged
Retrospective Studies
Risk Factors
Thrombosis - diagnostic imaging
Thrombosis - drug therapy
Tomography, X-Ray Computed
Treatment Outcome
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Summary:Background: Spontaneous isolated dissection of the superior mesenteric artery (SMA) is uncommon. Because of its rarity, the risk factors, aetiology and natural history are unclear, and there is no consensus on the optimal treatment strategy. Methods: Seven consecutive patients with symptomatic spontaneous isolated SMA dissection who received conservative treatment between March 2003 and February 2008 were included in this study. Their clinical characteristics, treatment methods and outcomes were analysed retrospectively. Results: Acute abdominal pain was the most common clinical manifestation. Initial contrast‐enhanced dynamic computed tomography (CT) showed isolated SMA dissection with partial thrombosis in all seven patients. Full anticoagulation was carried out immediately after the diagnosis. Clinical symptoms disappeared within 14 days and follow‐up CT showed complete resolution of the dissection in four patients. After a mean follow‐up of 23 months, there was no mortality or morbidity related to the dissection. Conclusion: In patients with symptomatic spontaneous isolated dissection of the SMA, conservative management is feasible if there is no evidence of bowel infarction or bleeding. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Settles with anticoagulation
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.6631