2007 Volume 27 Issue 4 Pages 651-653
Segmental arterial mediolysis (SAM) can cause abdominal apoplexy. We report the case of a 65-year-old man who presented with moderately acute abdominal pain. Abdominal and pelvic computed tomography examinations demonstrated intraperitoneal effusion and phlegmon-like hypertrophy of the mesentery. A diagnosis of intraperitoneal hemorrhage was made by exploratory puncture under ultrasound guidance. A visceral angiography revealed the irregular dilatation of the right colic artery, and a diagnosis of SAM was made based on this finding. While our case was cured with conservative treatment, surgical intervention should be initiated without delay because of the high mortality rate associated with intraperitoneal apoplexy. Because there was no intervention, this is the first reported case of the natural history of SAM leading to abdominal apoplexy.
