title: Treatment results for spontaneous isolated superior mesenteric artery dissection according to our previous guidelines and collective literature review.
abstract: BACKGROUND
  Isolated superior mesenteric artery dissection (ISMAD) is not a rare disease. However, its optimal treatment strategy has not yet been established.
  
  
  METHODS
  This study included 13 consecutive patients with ISMAD who were treated between April 2010 and July 2013 according to published treatment guidelines. Through a literature search, 10 studies on treatments and outcomes for ISMAD that were published from 2007 to the present were analyzed.
  
  
  RESULTS
  In the present study, 11 patients had acute onset abdominal pain and 2 patients were asymptomatic. Twelve patients were treated with conservative treatment, whereas 1 patient underwent coil embolization. In the literature review, initial conservative treatment, endovascular procedure, and surgical repair were done in 172, 25, and 14 patients, respectively. Bowel resection was done in 8 patients (3.7%) due to bowel necrosis. Conservative treatment failed in 15 patients (6.8%) during follow-up.
  
  
  CONCLUSIONS
  If bowel necrosis or arterial rupture was not present, conservative treatment of ISMAD was a safe and effective treatment. Aneurysmal type IV patients on computed tomography scan should be carefully followed up, and if there is a recurrence of pain or aneurysmal progression, an endovascular procedure could be safely performed.
authors.affiliation: College of Nursing, Eulji University, Daejeon, Korea.
authors.forename: Hye Young
authors.initials: HY
authors.lastname: Ahn
authors.affiliation: Department of Surgery, Eulji University Hospital, Daejeon, Korea. Electronic address: isunjoe@gmail.com.
authors.forename: Byung Sun
authors.initials: BS
authors.lastname: Cho
authors.affiliation: Department of Surgery, Eulji University Hospital, Daejeon, Korea.
authors.forename: Yun Su
authors.initials: YS
authors.lastname: Mun
authors.affiliation: Department of Surgery, Eulji University Hospital, Daejeon, Korea.
authors.forename: Je Ho
authors.initials: JH
authors.lastname: Jang
authors.affiliation: Department of Surgery, Eulji University Hospital, Daejeon, Korea.
authors.forename: Chang Nam
authors.initials: CN
authors.lastname: Kim
authors.affiliation: Department of Surgery, Eulji University Hospital, Daejeon, Korea.
authors.forename: Moon Soo
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Department of Surgery, Eulji University Hospital, Daejeon, Korea.
authors.forename: Yoon Jung
authors.initials: YJ
authors.lastname: Kang
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome