Abstract
Spontaneous dissection of the superior mesenteric artery (SMA) is a rare occurrence, especially when not associated with aortic dissection. When it does occur, it commonly causes aneurysmal rupture or intestinal ischemia. The cause and natural history of isolated dissection of the SMA are unknown. Because of the scarcity of reported cases, no standard medical or surgical treatment has been established. Recently, some conservatively treated cases involving isolated dissection of the SMA have been reported. Five patients with isolated dissection of the SMA who were treated conservatively at our hospital between 2000 and 2006 were studied. The 5 patients comprised 4 men and one woman whose ages ranged from 39 to 62 years, with a mean age of 50 years. Because of increasing pain, one case underwent laparotomy, but surgical treatment was not needed because direct visualization of the intestine showed no ischemia. All five cases experienced full recovery with conservative management and remain free from this disease. Isolated dissection of SMA is rare, with only 56 patients, including our own, reported in the literature in Japan. This disease should be kept in mind for the differential diagnosis of abdominal pain as it may otherwise fail to be detected. Rapid diagnosis is necessary in order to choose the appropriate therapy (surgical or conservative) for isolated SMA dissection.
