Isolated Dissection of Superior Mesenteric Artery: Study on the Treatment Guidelines
Journal of the Korean Surgical Society
;
: 64-70, 2010.
Article
in Korean
| WPRIM
| ID: wpr-37495
ABSTRACT
PURPOSE:
Isolated superior mesenteric artery (SMA) dissection is a rare, but increasing vascular disorder. However, optimal treatment guidelines are not well established. The purpose of this study is to review a single institutional experience in the management of isolated SMA dissections and establish optimal treatment guidelines.METHODS:
Between November 2004 and August 2009, 26 patients were diagnosed with isolated SMA dissection at Eulji University Hospital. Diagnosis was confirmed with CT scans in all patients. We retrospectively reviewed the medical records, imaging studies, and the early outcomes of the patients.RESULTS:
There were 22 (84.5%) men and 4 women. The mean age was 55.4 (39~74) years. The mean follow-up was 39.1 (4.1~53.3) months. In 15 patients, CT scans were performed for abdominal pain, and in the other 11 patients, the isolated SMA dissections were detected incidentally during workup for other causes. The radiographic findings included an intimal flap with a patent false lumen in 16 and intramural hematoma in 10. The dissection started at a mean of 22.3 (5~46) mm from the origin of the SMA with a mean length was 47.7 (10~150) mm. Treatments included expectant management in 13, anticoagulation in 6, stenting in 6 patients, and surgery in one case of bowel infarction. None required additional intervention. All patients remained asymptomatic during follow-up.CONCLUSION:
Most patients with isolated SMA dissection were successfully managed medically. Surgical or percutaneous intervention should be reserved for those with evidence of bowel necrosis or mesenteric ischemia and failed cases to initial medical treatment.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Abdominal Pain
/
Stents
/
Medical Records
/
Retrospective Studies
/
Follow-Up Studies
/
Mesenteric Artery, Superior
/
Hematoma
/
Infarction
/
Ischemia
/
Necrosis
Type of study:
Practice guideline
/
Observational study
/
Prognostic study
Limits:
Female
/
Humans
/
Male
Language:
Korean
Journal:
Journal of the Korean Surgical Society
Year:
2010
Type:
Article
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