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Non-operative management of isolated spontaneous superior mesenteric artery dissection

Isolated spontaneous superior mesenteric artery (SMA) dissection is a rare differential for patients presenting with abdominal pain. Due to limited cases reported, management strategies have been poorly defined. We present the case of a 49-year-old male with history of hypertension and ischemic coli...

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Autores principales: Ullrich, Lauryn A, Streiff, William, Mariner, David R, Song, Boyoung, Obmann, Melissa A, Nikam, Shivprasad D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207843/
https://www.ncbi.nlm.nih.gov/pubmed/30397433
http://dx.doi.org/10.1093/jscr/rjy274
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author Ullrich, Lauryn A
Streiff, William
Mariner, David R
Song, Boyoung
Obmann, Melissa A
Nikam, Shivprasad D
author_facet Ullrich, Lauryn A
Streiff, William
Mariner, David R
Song, Boyoung
Obmann, Melissa A
Nikam, Shivprasad D
author_sort Ullrich, Lauryn A
collection PubMed
description Isolated spontaneous superior mesenteric artery (SMA) dissection is a rare differential for patients presenting with abdominal pain. Due to limited cases reported, management strategies have been poorly defined. We present the case of a 49-year-old male with history of hypertension and ischemic colitis, presenting with abdominal pain. CT imaging demonstrated a thrombosed dissection of the SMA extending into second and third order braches. He was managed conservatively with therapeutic anticoagulation. His symptoms improved and upon discharge he was transitioned to aspirin and warfarin. Repeat CT imaging continued to show the dissection with resolution of the SMA thrombus. Spontaneous SMA dissection is exceedingly rare with no universally agreed upon standard of care for treatment. Operative intervention should be reserved for failed conservative management or vascular compromise. Understanding the current treatment options helps ensure a favorable patient outcome.
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spelling pubmed-62078432018-11-05 Non-operative management of isolated spontaneous superior mesenteric artery dissection Ullrich, Lauryn A Streiff, William Mariner, David R Song, Boyoung Obmann, Melissa A Nikam, Shivprasad D J Surg Case Rep Case Report Isolated spontaneous superior mesenteric artery (SMA) dissection is a rare differential for patients presenting with abdominal pain. Due to limited cases reported, management strategies have been poorly defined. We present the case of a 49-year-old male with history of hypertension and ischemic colitis, presenting with abdominal pain. CT imaging demonstrated a thrombosed dissection of the SMA extending into second and third order braches. He was managed conservatively with therapeutic anticoagulation. His symptoms improved and upon discharge he was transitioned to aspirin and warfarin. Repeat CT imaging continued to show the dissection with resolution of the SMA thrombus. Spontaneous SMA dissection is exceedingly rare with no universally agreed upon standard of care for treatment. Operative intervention should be reserved for failed conservative management or vascular compromise. Understanding the current treatment options helps ensure a favorable patient outcome. Oxford University Press 2018-10-31 /pmc/articles/PMC6207843/ /pubmed/30397433 http://dx.doi.org/10.1093/jscr/rjy274 Text en Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2018. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Ullrich, Lauryn A
Streiff, William
Mariner, David R
Song, Boyoung
Obmann, Melissa A
Nikam, Shivprasad D
Non-operative management of isolated spontaneous superior mesenteric artery dissection
title Non-operative management of isolated spontaneous superior mesenteric artery dissection
title_full Non-operative management of isolated spontaneous superior mesenteric artery dissection
title_fullStr Non-operative management of isolated spontaneous superior mesenteric artery dissection
title_full_unstemmed Non-operative management of isolated spontaneous superior mesenteric artery dissection
title_short Non-operative management of isolated spontaneous superior mesenteric artery dissection
title_sort non-operative management of isolated spontaneous superior mesenteric artery dissection
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207843/
https://www.ncbi.nlm.nih.gov/pubmed/30397433
http://dx.doi.org/10.1093/jscr/rjy274
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