Diagnosis of spontaneous isolated superior mesenteric artery dissection with ultrasound: A case report

Abstract

BACKGROUND

Spontaneous isolated superior mesenteric artery dissection (SISMAD) is a rare disease that originates from the superior mesenteric artery, without the presence of aortic and other arterial dissections. Most cases are diagnosed using contrast-enhanced computed tomography (CECT), whereas the application of ultrasound is less common.

CASE SUMMARY

Here, we report a case of SISMAD with sudden epigastric pain that worsened as the main symptom after eating. The patient had a long history of hypertension with unknown blood pressure control but no history of smoking or alcohol consumption. This case was initially diagnosed using ultrasound and the results were later confirmed by CECT. After admission, the patient fasted, followed by parenteral nutrition support and fluid supplementation to maintain electrolyte and acid–base balance. Metoprolol succinate sustained-release tablets and aspirin were given as nonoperative treatments. After 1 wk, the symptoms improved, and the patient was discharged. During telephone follow-up, the patient did not develop similar symptoms.

CONCLUSION

Whether ultrasound can be used as a routine and noninvasive imaging method for the diagnosis of SISMAD needs further exploration.

Keywords: Abdominal pain; Ultrasound; Spontaneous isolated superior mesenteric artery dissection; Color doppler; Diagnosis; Case report

Core tip: Spontaneous isolated superior mesenteric artery dissection is a rare disease. Contrast-enhanced computed tomography (CECT) is often the preferred diagnostic method for this disease. The initial diagnosis of this disease by ultrasound is rarely reported. Compared to CECT, ultrasound is a convenient, rapid, noninvasive, inexpensive and feasible bedside imaging method, which can be used to diagnose superior mesenteric artery dissection.