Superior mesentertic arterial (SMA) dissection is an uncommon type of arterial dissection. It can either on its own (rarer) or occur as part of an extension of an aortic dissection.
A spontaneous dissection of the superior mesenteric artery (SMA) is considered the most frequently reported type of visceral artery dissection 3,7.
Patients often present in middle age (50-60 of age). There is a recognised increased male predilection.
In isolated SMA dissections it usually begins a few centimeters from the SMA origin 4.
Patients can present with vague abdominal pain, the pain being especially worse after a meal. An SMA dissection is considered more symptomatic than a celiac artery dissection 3.
On non-contrast CT, the SMA is often enlarged. Post contrast images often show a flap within the vessel in acute situations. In an acute state, there can also be increased attenuation of the fat plane around the SMA 4.
Treatment and prognosis
Different therapeutic approaches are possible ranging from conservative management to surgical revascularisation to endovascular therapy 8. The prognosis is variable and it can sometimes be fatal.
History and etymology
It was first reported in 1947, Bauersfeld et.al. 1
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