Isolated superior mesenteric artery dissection managed with stent replacement and diagnostic laparoscopy: A case study

Abstract

Isolated superior mesenteric artery (SMA) dissection is a condition without aortic dissection. However, its diagnosis or treatment is not established. A 44-year-old man was brought to the emergency department with sudden onset of abdominal pain. Contrast-enhanced abdominal computed tomography revealed isolated SMA dissection and cecal pneumatosis intestinalis; thus, intestinal necrosis was suspected. Emergency stent replacement was performed for isolated SMA dissection, and then laparoscopy was performed to confirm the absence of intestinal necrosis using indocyanine green (ICG) fluorescence imaging, thereby avoiding intestinal resection. The postoperative course was good; thus, the combination of stent replacement and laparoscopy with ICG fluorescence imaging for isolated SMA dissection was considered minimally invasive and useful.