title: Spontaneous dissection with rupture of the superior mesenteric artery from segmental arterial mediolysis.
abstract: Spontaneous dissection of the superior mesenteric artery (SMA) is rare. We report a case of rupture of the SMA after spontaneous dissection in a 51-year-old male who presented with acute onset of abdominal pain and hypotension. The patient was initially treated with intravenous fluid resuscitation and endovascular intervention followed by open surgery. No identifiable cause for dissection was found. The patient was diagnosed as having segmental arterial mediolysis (SAM). The patients' presentation, treatment, outcome, and all relevant imaging, pathologic, and laboratory studies were reviewed. The relevant features of the case and SAM are presented herein. In addition, a review of all available published literature on SAM to date is presented.
authors.affiliation: Pennsylvania Hospital, Section of Vascular Surgery, 700 Spruce Street, Suite 101, Philadelphia, PA 19106, USA. revolutionmnt@hotmail.com
authors.forename: Michael N
authors.initials: MN
authors.lastname: Tameo
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Dougherty
authors.forename: Keith D
authors.initials: KD
authors.lastname: Calligaro
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D057510:Endovascular Procedures; D006801:Humans; D007022:Hypotension / Q000209:etiology; D008026:Ligation; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D014656:Vascular Surgical Procedures