title: Conservative treatment for isolated superior mesenteric artery dissection.
abstract: OBJECTIVE
  The treatment guidelines for isolated superior mesenteric artery (SMA) dissection have not been established. We assessed 14 cases of SMA dissection and reviewed the literature on this entity.
  
  
  METHODS
  The subjects were 11 men and 3 women (average age 64 years), with SMA dissection diagnosed by computed tomography (CT) scan or digital subtraction angiography, between 2001 and 2009, at our institution. Eight patients presented with symptoms such as abdominal pain, but SMA dissection was diagnosed incidentally during investigations of another illness in six patients. Thirteen patients were treated conservatively with anticoagulation and/or antiplatelet drugs, but one underwent exploratory laparotomy. The median follow-up period was 22 months.
  
  
  RESULTS
  The symptoms did not worsen, and ultimately resolved in the eight patients who had symptoms. Isolated dissection improved dramatically in two of the six patients with obstruction of the false lumen and was not seen on computed tomography (CT) scans 1 and 3 months after its onset.
  
  
  CONCLUSIONS
  We recommend conservative treatment as the first choice for isolated SMA dissection, even if the patient has abdominal pain and tenderness, given that there are no signs of peritonitis.
authors.affiliation: Departments of Advanced Regulatory Vascular Surgery, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima Bunkyo-ku, Tokyo, 113-8519, Japan. jibiki.srg1@tmd.ac.jp
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Jibiki
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Inoue
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Kudo
mesh_terms: D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015901:Angiography, Digital Subtraction; D000925:Anticoagulants / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors