Segmental Arterial Mediolysis and its Mimickers: A Case Report and Review of the Literature

This case report addresses segmental arterial mediolysis (SAM), a rare non-inflammatory vasculopathy. A 51-year-old man presented at the emergency department for epigastric and left upper quadrant pain. He had a history of arterial hypertension and had recently received methylprednisolone for knee pain. Blood tests revealed elevated C-reactive protein levels at 40 mg/l and lactate dehydrogenase levels at 496 IU/ml. Abdominal computerized tomography showed arterial thickening, arterial dilatations, and dissections of the splenic and renal arteries, leading to organ ischemia. This case emphasizes the importance of considering SAM in cases of unexplained abdominal pain or suspected arteriopathy. LEARNING POINTS: Segmental arterial mediolysis (SAM) is a rare and underdiagnosed vasculopathy. SAM is a challenging diagnosis and should not be confused with vasculitis. SAM has a good prognosis with spontaneous resolution in most cases.