Superior mesenteric artery spontaneous and isolated dissection diagnosed by using MDCTA

L. Saba 1, R. Sanfilippo 2, M. Atzeni 3, D. Ribuffo 3, R. Montisci 2, G. Mallarini 1,4

1 Department of Radiology; 2 Department of Vascular Surgery and 3 Department of Surgery, Section of Plastic Surgery; Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Polo di Monserrato, Cagliari (Italy); 4 Institute of Radiology, San Giovanni di Dio Hospital, Cagliari (Italy)

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• Radiology

We report the case of a 49-year-old man admitted to our Institute because he suffered acute abdominal pain induced by eating. Sonography don’t revealed pathological findings. Then underwent a multi-detector row computed tomography angiography (MDCTA) that revealed an intimal flap separating true and false lumens that was located 2 cm from the origin of the superior mesenteric artery (SMA) and with an extension of 8 cm. Since the dissection was limited without occlusion of the SMA and the mesenteric marginal artery served as a collateral vessel on the distal side of the SMA, the treatment has been conservative. Improved CT technology facilitates the diagnosis of superior mesenteric artery dissection. Prompt diagnosis and treatment result in the lowest mortality rate and minimize the prevalence of intestinal infarction. Only 107 cases (including the present case) of isolated spontaneous SMA dissection without associated aortic dissection were identified from the literature.

Corresponding Author: Luca Saba, MD; e-mail: lucasaba@tiscali.it

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