Early detection of a rare case: Idiopathic spontaneous superior mesenteric artery dissection, by duplex ultrasonography
Spontaneous dissection of the superior mesenteric artery (SMA) without involvement of the aorta is an extremely rare condition. It could be a surgical emergency because ischaemic intestine due to artery occlusion is life-threatening and the prognosis is time-dependent. We present a 55-year-old man w...
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Published in | Hong Kong journal of emergency medicine Vol. 22; no. 3; pp. 189 - 193 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
London, England
SAGE Publications
01.05.2015
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Subjects | |
Online Access | Get full text |
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Summary: | Spontaneous dissection of the superior mesenteric artery (SMA) without involvement of the aorta is an extremely rare condition. It could be a surgical emergency because ischaemic intestine due to artery occlusion is life-threatening and the prognosis is time-dependent. We present a 55-year-old man with a 5-day history of progressive abdominal pain. He had a negative laboratory work-up and pan-endoscopy showed multiple gastric ulcers. Despite treatment, he had persistent severe epigastric pain disproportionate to physical findings. Bedside duplex ultrasonography revealed the absence of color signal in the proximal SMA. Angiography confirmed the diagnosis of SMA dissection. Mesenteric vascular emergency including arterial dissection should be taken into consideration in patients who present with severe abdominal pain of unknown origin. Abdominal bruit may be the only vital clue but is usually difficult in the noisy emergency department. Duplex ultrasonography can be helpful to detect blood flow abnormality whenever in doubt. |
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Bibliography: | HKJEM_c.jpg Hong Kong Journal of Emergency Medicine, Vol. 22, No. 3, May 2015: [189]-193 |
ISSN: | 1024-9079 2309-5407 |
DOI: | 10.1177/102490791502200309 |