Isolated Superior Mesenteric Artery Dissection, A Rare Cause Of Abdominal Pain.

ABSTRACT

A 42-year-old previously healthy male presented with 5 days of spontaneous mid-epigastric intense abdominal pain and mild epigastric tenderness on palpation. CT angiography revealed a Sakamoto type 2 isolated superior mesenteric artery dissection (SMA) with a "cul-de-sac" shaped false lumen (B- C large arrow), side branch perfusion from both lumens, and compression of the true (A-D small arrow) by the false lumen (A-D large arrow). Dissection flap presented just distal to an aberrant right hepatic artery arising from the SMA (B.D star). CT, clinical and analytic findings did not suggest visceral compromise and was successfully treated with bowel rest and anticoagulation. He is now on close clinical and imaging follow-up.