ACR Codes: 956.9
Spontaneous SMA dissections are exceptional events. During a period of 52 years, only 35 cases (including this one) have been reported. Nevertheless, they represent the most frequent type of digestive artery dissection, with those of the hepatic artery, splenic artery, left gastric artery, and celiac artery being even less frequent.
Patients with SMA dissections are predominantly male (88%) and have an average age of 55 years (between 45 and 87 years). Whereas atherosclerosis, fibromuscular dysplasia, cystic medial necrosis, and connective tissue disorders (Marfan’s, Elhers-Danlos syndromes) are often mentioned as possible causes. In most cases no cause could be found. Other possible etiologies of isolated SMA dissection include iatrogenic or blunt trauma and segmental mediolytic arteriopathy.
Segmental mediolytic ateriopathy is an uncommon nonatherosclerotic and nonvasculitic disease, characterized by lytic degeneration of the arterial media, intramural dissection, and thrombosis or ruptured aneurysm and mainly involves the intraabdominal arterial system. However, a few cases of involvement of intracranial arteries have been reported.
Reference(s): Lamprecht G, Trabold T, Gregor M, Lamberts R. Spontaneous, self-limited, non-atherosclerotic dissection of the superior
mesenteric artery. Eur J Gastroenterol Hepatol. 2003 Apr;15(4):437-9.
Sartelet H, Fedaoui-Delalou D, Capovilla M, Marmonier MJ, Pinteaux A, Lallement PY. Fatal hemorrhage due to an isolated dissection of the superior mesenteric artery. Intensive Care Med. 2003 Mar;29(3):505-6.
Javerliat I, Becquemin JP, d'Audiffret A. Spontaneous isolated dissection of the superior mesenteric artery. Eur J Vasc Endovasc Surg. 2003 Feb;25(2):180-4. Review.
Lorelli DR, Cambria RA, Seabrook GR, Towne JB. Diagnosis and management of aneurysms involving the superior mesenteric artery and its branches--a report of four cases. Vasc Endovascular Surg. 2003 Jan-Feb;37(1):59-66.
Takayama H, Takeda S, Saitoh SK, Hayashi H, Takano T, Tanaka K. Spontaneous isolated dissection of the superior mesenteric artery. Intern Med. 2002 Sep;41(9):713-6.
Hirai S, Hamanaka Y, Mitsui N, Isaka M, Kobayashi T. Spontaneous and isolated dissection of the main trunk of the superior mesenteric artery. Ann Thorac Cardiovasc Surg. 2002 Aug;8(4):236-40.
Goueffic Y, Costargent A, Dupas B, Heymann MF, Chaillou P, Patra P. Superior mesenteric artery dissection: case report. J Vasc Surg. 2002 May;35(5):1003-5.
Furukawa H, Moriyama N. Spontaneous dissection of the superior mesenteric artery diagnosed on multidetector helical CT. J Comput Assist Tomogr. 2002 Jan-Feb;26(1):143-4.
Sakata N, Takebayashi S, Shimizu K, Kojima M, Masawa N, Suzuki K, Takatama M. A case of segmental mediolytic arteriopathy involving both intracranial and intraabdominal arteries. Pathol Res Pract. 2002;198(7):493-7; discussion 499-500.
Use this for Comments and SuggestionsMedPix® is sponsored by the Department of Radiology and Radiological Sciences, USUHS, Bethesda, MD We do not accept paid advertisements.
Disease Topic 4846 
Click Here for MedPix®-2
for Comments and Suggestions
