Abstract
Isolated dissection of a splanchnic artery, including the celiac artery or superior mesenteric artery (SMA) is relatively rare. The cause, natural history, gender relationship, and prognosis are unknown.
In addition to the 165 patients already reported in Japan already, treated in our department were added and we reviewed all cases to survey demographic data, the location of dissection, and the length of dissection, symptoms, diagnostic modalities, treatments, and prognosis.
The overall mean age was 55.0 years old (from 31 to 89). There were 157 men (91.3%), and only 15 women (8.7%). There were 128 patients with acute abdominal pain (94.8%). 68.8% of chronic patients did not have any symptoms and were found by chance. In all cases, the most common of the beginning of the dissection were within 3 cm (94.6%) from the ostium, and the mean value was 1.8 cm. The mean length of dissection was 5.3 cm. Conservative therapy was performed for 74.4% of patients, and 25.6% underwent surgical and/or catheter intervention. Only 3 fatalities have been reported. There was no significant difference incases with or without antithrombotic therapy in terms of the radiological patency of false lumen.
Of the 7 cases of splanchnic arterial dissection treated at our facility, 6 had successful outcomes. In many cases, the clinical course of splanchnic artery dissection was benign. However, it is important to not miss the signs of severe bowel ischemia. Antithrombotic therapy does not appear to affect the patency of the false lumen.
