Isolated spontaneous dissection of the splanchnic arteries.
OBJECTIVE
Isolated dissection of a splanchnic artery, including the celiac artery, superior mesenteric artery (SMA), and inferior mesenteric artery, and their branches, is a relatively rare condition. This study was conducted to define the characteristics of patients with splanchnic artery dissection and the clinical course of isolated splanchnic artery dissection.


METHODS
The records of 19 patients were reviewed to survey demographic data, the location of dissection, symptoms, diagnostic modalities, treatment, and long-term outcome.


RESULTS
The locations of dissection were the superior mesenteric artery (SMA) in 11 patients, celiac artery in 3, both celiac artery and SMA in 2, and common hepatic artery, celiac artery to splenic artery, and celiac artery to proper hepatic artery in 1 each. In all but one with systemic sclerosis and Sjögren syndrome, the underlying cause of dissection was unclear. There were 12 asymptomatic and seven symptomatic patients. All cases were diagnosed by computed tomography. Surgical treatment was performed in one patient with a large aneurysm of the common hepatic artery, and the remaining 18 patients were followed-up conservatively. The mean follow-up duration was 20.9 +/- 25.4 months (range, 2-116 months). No expansion or progression of the false lumen was observed in these patients.


CONCLUSIONS
Patients with spontaneous dissection of the splanchnic arteries are often asymptomatic, and in this series, none developed significant end organ ischemia. Most patients with this rare condition can be managed expectantly with clinical follow-up including computed tomography imaging to assess aneurysm formation.
Takayama
Toshio
T
Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Miyata
Tetsuro
T
Shirakawa
Motoaki
M
Nagawa
Hirokazu
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D000792:Angiography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D002445:Celiac Artery / Q000000981:diagnostic imaging; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D015994:Incidence; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D008643:Mesentery / Q000098:blood supply*; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D013152:Splanchnic Circulation / Q000502:physiology; D013157:Splenic Artery / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler