title: Conservative treatment for isolated dissection of the superior mesenteric artery: Report of two cases.
abstract: BACKGROUND
  Isolated spontaneous dissection of the superior mesenteric artery (SMA) is rare and a treatment strategy has not been established yet. In this paper, we present our experience with two cases and review the literature.
  
  
  METHODS
  Both cases were treated conservatively as they did not show signs of bowel ischemia. They were symptom free with no evidence of disease progression after a median follow-up of 3.5 years.
  
  
  CONCLUSIONS
  There are three methods for the treatment of isolated SMA dissection; observation with medical therapy, endovascular surgery, and open surgery. Most patients with isolated SMA dissection can be treated with observation alone. Although the indications for surgery are still controversial, patients with bowel ischemia should undergo invasive treatment in the form of either endovascular or open surgery.
  
  
  CONCLUSIONS
  We recommend observation with medical therapy as the first choice for isolated SMA dissection. However, long term follow-up is necessary as the extent of the dissection may change over time.
authors.affiliation: Division of Surgery, JA Mie Komono Public Welfare Hospital, 75 Fukumura, Komono-cho, Mie 5101234, Japan. Electronic address: funa84@aol.com.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Funahashi
authors.affiliation: Division of Surgery, JA Mie Komono Public Welfare Hospital, 75 Fukumura, Komono-cho, Mie 5101234, Japan. Electronic address: n-shinagawa@kkh.miekosei.or.jp.
authors.forename: Naoya
authors.initials: N
authors.lastname: Shinagawa
authors.affiliation: Division of Surgery, JA Mie Komono Public Welfare Hospital, 75 Fukumura, Komono-cho, Mie 5101234, Japan. Electronic address: t-saitoh@kkh.miekosei.or.jp.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Saitoh
authors.affiliation: Division of Surgery, JA Mie Komono Public Welfare Hospital, 75 Fukumura, Komono-cho, Mie 5101234, Japan. Electronic address: y-takeda@kkh.miekosei.or.jp.
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Takeda
authors.affiliation: Division of Surgery, JA Mie Komono Public Welfare Hospital, 75 Fukumura, Komono-cho, Mie 5101234, Japan. Electronic address: a-iwai@kkh.miekosei.or.jp.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Iwai
keywords: Conservative therapy; Isolated SMA dissection case reports