2019 Volume 39 Issue 5 Pages 993-996
A 56–year–old man was transferred to our emergency department with acute lower abdominal pain following recurrent vomiting. Contrast–enhanced CT showed findings of cholecystitis and cholangitis with a small biliary stone located around the papilla of Vater. In addition, a superior mesenteric arterial dissection with entry at 2.5cm from its origin was identified. There was no acute intestinal ischemia or aneurysmal dilatation of the superior mesenteric artery and thus, conservative therapy was chosen. Retrieve of common bile duct stones and placement of a bile duct tube under endoscopic retrograde cholangiopancreatography was performed for the next day, and two weeks later, a laparoscopic cholecystectomy was executed. Follow–up CT findings obtained 2 months and 7 months after the initial event showed an improvement of narrowing of the true lumen and thus, the patient is being followed up with contrast–enhanced CT on an annual basis. In this case, we suggest that cholecystitis and cholangitis served as the initial trigger for the isolated superior mesenteric arterial dissection.
