Conservative treatment for isolated superior mesenteric artery dissection
Conservative treatment for isolated superior mesenteric artery dissection
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DOI：
10.1007/s00595-012-0304-8
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发表时间：
2013-03-01
期刊：
影响因子：
2.5
通讯作者：
Kudo, Toshifumi
中科院分区：
文献类型：
--
作者：
Jibiki, Masatoshi;Inoue, Yoshinori;Kudo, Toshifumi
孤立性上级肠系膜动脉（SMA）夹层的治疗指南尚未确立。我们评估了14例SMA夹层病例并回顾了有关该实体的文献，受试者为11例男性和3例女性（平均年龄64岁），均于2001年至2009年在我们的机构通过计算机断层扫描（CT）扫描或数字减影血管造影诊断为SMA夹层。8例患者出现腹痛等症状，但在6例患者的另一种疾病调查期间偶然诊断出SMA夹层。13例患者接受抗凝和/或抗血小板药物保守治疗，但1例接受剖腹探查术。中位随访时间为22个月，8名出现症状的患者的症状没有恶化，最终得到缓解。孤立性夹层显着改善，在两个6例假腔阻塞，并没有看到计算机断层扫描（CT）扫描后1个月和3 monthsituation.We建议保守治疗孤立SMA夹层的首选，即使患者有腹痛和压痛，鉴于没有腹膜炎的迹象。
The treatment guidelines for isolated superior mesenteric artery (SMA) dissection have not been established. We assessed 14 cases of SMA dissection and reviewed the literature on this entity.The subjects were 11 men and 3 women (average age 64 years), with SMA dissection diagnosed by computed tomography (CT) scan or digital subtraction angiography, between 2001 and 2009, at our institution. Eight patients presented with symptoms such as abdominal pain, but SMA dissection was diagnosed incidentally during investigations of another illness in six patients. Thirteen patients were treated conservatively with anticoagulation and/or antiplatelet drugs, but one underwent exploratory laparotomy. The median follow-up period was 22 months.The symptoms did not worsen, and ultimately resolved in the eight patients who had symptoms. Isolated dissection improved dramatically in two of the six patients with obstruction of the false lumen and was not seen on computed tomography (CT) scans 1 and 3 months after its onset.We recommend conservative treatment as the first choice for isolated SMA dissection, even if the patient has abdominal pain and tenderness, given that there are no signs of peritonitis.