title: Isolated Superior Mesenteric Artery Dissection with Small Intestine Ischemia.
abstract: Superior mesenteric artery (SMA) dissection without aortic dissection is a rare condition, and its diagnosis is considered to be difficult. Intestinal infarction is a severe complication of the disease, which may require resection of the intestine. We present a case of isolated SMA dissection. A 53-year-old man experienced sudden pain in the abdomen while playing Japanese pinball and was admitted to our hospital due to acute abdominal symptoms of uncertain cause. Enhanced CT revealed a defect of the root of the SMA, while angiography and intravascular ultrasound findings showed dissection of the SMA wall. Conservative treatment was chosen at the time, while a part of the small intestine was eventually resected because of progressive ischemia. Although SMA dissection is a rare occurrence in cases with acute abdominal symptoms, awareness of the condition is important for differential diagnosis.
authors.affiliation: Second Department of Internal Medicine, Shimane University School of Medicine, Izumo-shi, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Aimi
authors.affiliation: Department of Functional Pathology, Shimane University School of Medicine, Izumo-shi, Japan.
authors.forename: Chika
authors.initials: C
authors.lastname: Amano
authors.affiliation: Department of Radiology, Shimane University School of Medicine, Izumo-shi, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Yoshida
authors.affiliation: Department of Digestive Surgery, Shimane University School of Medicine, Izumo-shi, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsubara
authors.affiliation: Second Department of Internal Medicine, Shimane University School of Medicine, Izumo-shi, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Mikami
authors.affiliation: Second Department of Internal Medicine, Shimane University School of Medicine, Izumo-shi, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Izumi
authors.affiliation: Second Department of Internal Medicine, Shimane University School of Medicine, Izumo-shi, Japan.
authors.forename: Eiko
authors.initials: E
authors.lastname: Okimoto
authors.affiliation: Second Department of Internal Medicine, Shimane University School of Medicine, Izumo-shi, Japan.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Ishimura
authors.affiliation: Second Department of Internal Medicine, Shimane University School of Medicine, Izumo-shi, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Ishihara
authors.affiliation: Second Department of Internal Medicine, Shimane University School of Medicine, Izumo-shi, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kinoshita
keywords: Ischemia; Small intestine; Superior mesenteric artery dissection