Superior mesenteric arterial dissection

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.

Associations
Location

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.

CT: CTA

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

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.

It was first reported in 1947, Bauersfeld et.al. 1

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Article information

rID: 19851
System: Vascular
Tag: cases
Synonyms or Alternate Spellings:
  • Superior mesentery arterial (SMA) dissection
  • SMA dissection
  • Dissection of the SMA
  • Dissection of the superior mesentery artery
  • Superior mesenteric arterial (SMA) dissection

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