title: Successful treatment tailored to each splanchnic arterial lesion due to segmental arterial mediolysis (SAM): report of a case.
abstract: Segmental arterial mediolysis (SAM) is a rare condition characterized by splanchnic arterial catastrophe caused by mediolysis. We report a 59-year-old man with a ruptured splenic arterial aneurysm who was successfully treated by coil embolization. He underwent additional resection of large gastroepiploic and residual splenic aneurysms. Pathological examination showed mediolysis and tearing, compatible with SAM. Furthermore, he developed acute dissection of the superior mesenteric artery (SMA) one and a half years later, demonstrated by computed tomography. This report demonstrates that SAM is characterized by multiple lesions of the splanchnic arteries at different times, and requires treatment suited to the lesions, including careful long-term observation.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Juno
authors.initials: J
authors.lastname: Deguchi
authors.forename: Hisako
authors.initials: H
authors.lastname: Endo
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miyata
mesh_terms: D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D018450:Disease Progression; D004621:Embolization, Therapeutic; D024405:Gastroepiploic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D014656:Vascular Surgical Procedures