Presentation
Post prandial pain.
Patient Data
There is a luminal stenosis of the proximal SMA commencing approximately 15 mm from the origin associated with soft tissue density filling defect, irregular luminal contour and marked expansion of the caliber of the SMA. The morphology of the stenosis is quite irregular with a focal point approximately 60 mm from the origin where almost no contrast seen in the lumen. Distal to this however, the lumen is again seen favoring a tight stenosis over a complete occlusion. Importantly, this very tight stenosis is new compared to the imaging from 5 days ago. The stenosis extends almost to the ileocolic termination of the SMA. The celiac trunk, IMA and renal arteries of free of significant stenoses. There is no bowel dilatation or focal mural thickening to suggest bowel ischemia. No other abnormalities of the imaged gastrointestinal tract is identified. The liver, spleen, pancreas, adrenals and kidneys are unremarkable. Negligible bibasal atelectasis. No suspicious osseous lesion is identified.
Conclusion:
Appearances are consistent with a dissecting aneurysm of the SMA and is seen on the external imaging from 5 days prior. No evidence on CT of current bowel ischemia.
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