Management of spontaneous isolated intramural hematoma of the superior mesenteric artery: a single-center experience.
Langenbecks Arch Surg
; 407(3): 1217-1224, 2022 May.
Article
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| MEDLINE
| ID: mdl-34994827
ABSTRACT
PURPOSE:
To investigate the clinical course and optimal management for spontaneous isolated intramural hematoma of the superior mesenteric artery (SIHSMA).METHODS:
From January 2015 to October 2020, a total of 31 consecutive patients with SIHSMA were included in this study. The demographics, clinical features, treatment details, imaging information, and outcomes were reviewed.RESULTS:
There were 24 males and 7 females, with a mean age of 54.9 years (SD 6.9 years). Seven patients (7/31, 23%) were associated with ulcer-like projection (ULP), one patient (1/31, 3%) with intramural blood pool (IBP), and the remaining twenty-three patients (23/31, 74%) had no ULP or IBP. All patients were initially managed conservatively and underwent a median follow-up of 25.5 months (IQR 14.5, 39.9), which showed 3 patients (3/31, 10%) subsequently underwent stenting (2 within 7 days and 1 after 1.5 months), 1 patient (1/31, 3%) progressed to a localized dissection 7 months later but remained stable and asymptomatic until the time of writing, and the remaining patients (27/31, 87%) had no progression. In the present cohort, the overall survival was 100% (31/31). The free-from progression and stenting rate under conservative treatment was 87% (27/31). The invasive intervention rate was 10% (3/31). The natural complete regression rate of IMH in patients without ULP was higher than those with ULP (91% [21/23] vs. 29% [2/7], p = .003).CONCLUSION:
The majority of patients with SIHSMA can be managed conservatively. Patients with ULP seemed to have a lower IMH regression rate than those without ULP.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Arteria Mesentérica Superior
/
Hematoma
Tipo de estudio:
Observational_studies
Límite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2022
Tipo del documento:
Article