title: A case report of segmental arterial mediolysis in which computed tomography angiography was useful for diagnosis.
abstract: A 48-year-old male presented to our hospital with abdominal pain. Laboratory studies showed no abnormality, the severity of his abdominal pain decreased, and the patient was discharged. Five days later, the patient visited a neighborhood clinic because of fever with a 3-day history of temperatures of approximately 38 °C. The patient was admitted to our hospital 6 days after his initial visit. Laboratory investigation revealed a C-reactive protein level of 18.2 mg/dL. Abdominal computed tomography (CT) showed an 80 × 60 mm hematoma behind the descending colon, but no extravasation was detected. Thin-slice maximum-intensity-projection images from CT angiography (CTA) showed irregular narrowing and intermittent fusiform dilatations of the left colonic artery, suggesting a vascular disease, such as segmental arterial mediolysis (SAM). Digital subtraction angiography showed local irregularity, and 'beading and narrowing' of the left colonic artery, similar to the findings on CTA. Left hemicolectomy was electively performed on the twenty-fifth hospital day. Histological findings were consistent with SAM. Thus, CTA was a useful modality for the early diagnosis of SAM.
authors: Department of Gastroenterology, Sendai Medical Center, 2-8-8 Miyagino, Sendai, Miyagi 983-8520 Japan.
authors: Haruka
authors: H
authors: Yoshida
authors: Katsuaki
authors: K
authors: Ukai
authors: Mikako
authors: M
authors: Sugimura
authors: Hiromichi
authors: H
authors: Akoshima
authors: Kenji
authors: K
authors: Kimura
authors: Masahiro
authors: M
authors: Iwabuchi
authors: Keiichi
authors: K
authors: Tadokoro
authors: Hiroki
authors: H
authors: Takahashi
authors: Hiroya
authors: H
authors: Rikimaru
authors: Toshihiro
authors: T
authors: Saitoh
authors: Hiroyoshi
authors: H
authors: Suzuki
keywords: CT angiography (CTA); Digital subtraction angiography (DSA); Maximum-intensity-projection (MIP) images; Segmental arterial mediolysis