title: Spontaneous superior mesenteric artery (SMA) dissection: an unusual cause of abdominal pain.
abstract: A 44-year-old woman presented to our Emergency Department with a 4-day history of severe, sharp left upper quadrant abdominal pain associated with nausea and vomiting. She had been seen 3 days prior at another Emergency Department, and had a negative work-up including a normal non-contrast computed tomography (CT) scan of the abdomen/pelvis for possible kidney stone. Vital signs were: temperature 36.3°C (97.3°F), pulse 100 beats/min, respiratory rate 18 breaths/min, and blood pressure 141/80 mm Hg. Physical examination was remarkable for marked tenderness in the left upper and middle quadrants and voluntary guarding. Bowel sounds were normal. Although laboratory studies were normal, a CT scan of the abdomen/pelvis with intravenous contrast suggested a superior mesenteric artery dissection. This was confirmed with arteriography. The clinical presentation, diagnostic evaluation, and management of superior mesenteric artery dissection are reviewed.
authors.affiliation: Department of Emergency Medicine, Eastern Virginia Medical School, Norfolk, Virginia 23507, USA.
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Watring
authors.forename: Corbett M
authors.initials: CM
authors.lastname: Smith
authors.forename: Gordon K
authors.initials: GK
authors.lastname: Stokes
authors.forename: Francis L
authors.initials: FL
authors.lastname: Counselman
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000328:Adult; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D017538:Mesenteric Artery, Superior; D014057:Tomography, X-Ray Computed