Conservative Management of Spontaneous Isolated Dissection of the Superior Mesenteric Artery

Purpose. We report the clinical outcomes of patients with spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) who were treated conservatively. Materials and Methods. A retrospective review was performed in 14 patients from 2006 to 2016 with SIDSMA. Their clinical features and...

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Main Authors: Jae Hyun Kwon, Yoon Hee Han, Jun Kyu Lee
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2017/9623039
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author Jae Hyun Kwon
Yoon Hee Han
Jun Kyu Lee
author_facet Jae Hyun Kwon
Yoon Hee Han
Jun Kyu Lee
author_sort Jae Hyun Kwon
collection DOAJ
description Purpose. We report the clinical outcomes of patients with spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) who were treated conservatively. Materials and Methods. A retrospective review was performed in 14 patients from 2006 to 2016 with SIDSMA. Their clinical features and computed tomographic angiography (CTA) characteristics, treatment methods, and clinical outcomes were analyzed. The mean age was 53.6 (range, 41–73) years, and the mean follow-up duration was 20.6 (range, 1–54) months. Conservative management was the primary treatment if no bowel ischemia or arterial rupture was noted. Results. The mean initial abdominal visual analog pain score was 7 (range, 5–9) in seven patients. The mean total duration of abdominal pain was 10.2 days (range, 2–42 days) in 10 patients. The mean percentage stenosis of the dissected SMA at the initial presentation was 78.8% in 14 patients. Complete obstruction of the SMA at the initial presentation was evident in 4 of the 14 patients (28.6%). Conservative management was successful in all 14 patients. None of the 14 patients developed bowel ischemia or an infarction. Abdominal pain did not recur in any patient during follow-up (mean, 20.6 months; range, 1–54 months). Conclusion. Conservative management was successful for all SIDSMA patients, even those with severe compression of the true lumen or complete obstruction of the dissected SMA.
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spelling doaj-art-d99eff7d9a5a4cd7a66c3d6f8664e13b2025-08-20T02:21:12ZengWileyGastroenterology Research and Practice1687-61211687-630X2017-01-01201710.1155/2017/96230399623039Conservative Management of Spontaneous Isolated Dissection of the Superior Mesenteric ArteryJae Hyun Kwon0Yoon Hee Han1Jun Kyu Lee2Department of Radiology, Dongguk University Ilsan Hospital, Dongguk University Graduate School of Medicine, 27 Dongguk-ro, Siksa-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 10326, Republic of KoreaDepartment of Radiology, Dongguk University Ilsan Hospital, Dongguk University Graduate School of Medicine, 27 Dongguk-ro, Siksa-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 10326, Republic of KoreaDepartment of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University Graduate School of Medicine, 27 Dongguk-ro, Siksa-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 10326, Republic of KoreaPurpose. We report the clinical outcomes of patients with spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) who were treated conservatively. Materials and Methods. A retrospective review was performed in 14 patients from 2006 to 2016 with SIDSMA. Their clinical features and computed tomographic angiography (CTA) characteristics, treatment methods, and clinical outcomes were analyzed. The mean age was 53.6 (range, 41–73) years, and the mean follow-up duration was 20.6 (range, 1–54) months. Conservative management was the primary treatment if no bowel ischemia or arterial rupture was noted. Results. The mean initial abdominal visual analog pain score was 7 (range, 5–9) in seven patients. The mean total duration of abdominal pain was 10.2 days (range, 2–42 days) in 10 patients. The mean percentage stenosis of the dissected SMA at the initial presentation was 78.8% in 14 patients. Complete obstruction of the SMA at the initial presentation was evident in 4 of the 14 patients (28.6%). Conservative management was successful in all 14 patients. None of the 14 patients developed bowel ischemia or an infarction. Abdominal pain did not recur in any patient during follow-up (mean, 20.6 months; range, 1–54 months). Conclusion. Conservative management was successful for all SIDSMA patients, even those with severe compression of the true lumen or complete obstruction of the dissected SMA.http://dx.doi.org/10.1155/2017/9623039
spellingShingle Jae Hyun Kwon
Yoon Hee Han
Jun Kyu Lee
Conservative Management of Spontaneous Isolated Dissection of the Superior Mesenteric Artery
Gastroenterology Research and Practice
title Conservative Management of Spontaneous Isolated Dissection of the Superior Mesenteric Artery
title_full Conservative Management of Spontaneous Isolated Dissection of the Superior Mesenteric Artery
title_fullStr Conservative Management of Spontaneous Isolated Dissection of the Superior Mesenteric Artery
title_full_unstemmed Conservative Management of Spontaneous Isolated Dissection of the Superior Mesenteric Artery
title_short Conservative Management of Spontaneous Isolated Dissection of the Superior Mesenteric Artery
title_sort conservative management of spontaneous isolated dissection of the superior mesenteric artery
url http://dx.doi.org/10.1155/2017/9623039
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