Tearing abdominal pain…


This is a 60 year old male who presented with tearing abdominal pain…

SMA dissection 1

This CT angiogram of the abdomen shows a superior mesenteric artery dissection.  The aorta was normal.  On the above CT image you can see a flap dissecting the SMA.

SMA dissection is a rare pathology in the abdomen.  It can lead to localized mesenteric ischemia and presents with severe abdominal pain.  It is treated various ways including medical management and observation, endovascular repair, or surgical revascularization (1).  Many times it is associated with aortic dissection with a dissection flap extending into the SMA.

Image contributor:  James Chenoweth, MD

Author:  Russell Jones, MD

References

1.  Gobble RM, Brill ER, Rockman CB et-al. Endovascular treatment of spontaneous dissections of the superior mesenteric artery. J. Vasc. Surg. 2009;50 (6): 1326-32.

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EMREMS: Radiology in Emergency Medicine

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