Professional paper
Acute mesenteric ischemia caused by isolated dissection of the superior mesenteric artery and thrombotic occlusion of its major branches: treatment by systemic thrombolysis with recombinant tissue plasminogen activator (rtPA)
Andrej Bergauer
; Department of Vascular Surgery, University Hospital Maribor, Ljubljanska 5, 2000 Maribor
Nina Kobilica
; Department of Vascular Surgery, University Hospital Maribor, Ljubljanska 5, 2000 Maribor
Jože Matela
; Department of Radiology, University Hospital Maribor, Ljubljanska 5, 2000 Maribor
Vojko Flis
; Department of Vascular Surgery, University Hospital Maribor, Ljubljanska 5, 2000 Maribor
Abstract
Introduction. Isolated superior mesenteric artery (SMA) dissection, without associated aortic dissection, is relatively uncommon. Therefore, there are insufficient data to support a particular therapeutic option in the specific setting of isolated SMA dissection associated with thrombotic complications.
Case report. In this article we describe the diagnosis and treatment of a patient who presented to the Emergency Department with the clinical picture of an acute abdomen and signs suggestive of acute occlusion of the SMA. Diagnostic studies showed an isolated SMA dissection with acute thrombotic occlusion of its main branches. The patient was successfully treated with systemic recombinant tissue plasminogen activator (rtPA) thrombolysis. To the best of our knowledge, this is the first description of a case of isolated SMA dissection associated with thrombotic occlusion of its main branches.
Conclusion. In patients presenting with persistent abdominal pain and unspecific clinical findings, rare causes should be considered because of their life threatening complications. Systemic thrombolysis is a feasible technique for the treatment of isolated SMA dissection associated with thrombotic complications in the absence of bowel necrosis.
Keywords
acute intestinal ischemia; superior mesenteric artery; dissection; thrombosis; systemic lysis; recombinant tissue plasminogen activator (rtPA)
Hrčak ID:
60188
URI
Publication date:
1.10.2010.
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