A 48-year-old Man with Epigastric Pain and Melena
Archives of Academic Emergency Medicine,
Vol. 4 No. 4 (2016),
1 November 2016
,
Page 211-213
https://doi.org/10.22037/aaem.v4i4.253
Abstract
A 48-year-old male patient presented to the emergency department with the complaints of epigastric pain and melena for the past 3 days. The pain was started suddenly and has progressed and after a while, he passed melena stool. He also mentioned some episodes of vomiting that was not bloody. The pain score was about 8/10 (based on verbal quantitative scale) and slightly radiated to back. He loosed his appetite and the pain aggravated by meal. He did not use any drug regularly and had no positive medical history for specific disease or prior hospital admission. The patient was slightly pale and sweaty. His pulse rate was 80/minute and blood pressure was elevated as 180/100 mm Hg. Routine blood tests such as liver enzyme and serum amylase levels were normal. Complete blood cell count showed mild anemia (Haemoglobin =10 g/dl) and leucocytosis (16600/mm3). On physical examination, there were not any positive findings except mild epigastric tenderness without rebound or guarding. Electrocardiography revealed normal sinus rhythm without any pathologic findings. The patient was admitted in surgical ward and plain abdominal computed tomography (CT) scan and abdominal CT angiogram was done. The findings of CT are shown in figures 1A-D.- SMA Dissection
- Bowel Ischemia
- Emergency Surgery
How to Cite
References
Aydin S, Ergun E, Fatihoglu E, Durhan G, Kosar PN. Spontaneous Isolated Celiac Artery and Superior Mesenteric Artery Dissections: A Rare Case. Polish Journal of Radiology. 2015;80:470.
Tokue H, Tsushima Y, Endo K. Imaging findings and management of isolated dissection of the visceral arteries. Japanese journal of radiology. 2009;27(10):430-7.
Verde F, Bleich KB, Oshmyansky A, Black JH, Fishman EK, Johnson PT. Isolated celiac and superior mesenteric artery dissection identified with MDCT: imaging findings and clinical course. Journal of computer assisted tomography. 2012;36(5):539-45.
Katsura M, Mototake H, Takara H, Matsushima K. Management of spontaneous isolated dissection of the superior mesenteric artery: Case report and literature review. World J Emerg Surg. 2011;6:16.
Satokawa H, Takase S, Seto Y, Yokoyama H, Gotoh M, Kogure M, et al. Management strategy of isolated spontaneous dissection of the superior mesenteric artery. Annals of vascular diseases. 2014;7(3):232.
Mousa AY, Coyle BW, Affuso J, Haser PB, Vogel TR, Graham AM. Nonoperative management of isolated celiac and superior mesenteric artery dissection: case report and review of the literature. Vascular. 2009;17(6):359-64.
Gobble RM, Brill ER, Rockman CB, Hecht EM, Lamparello PJ, Jacobowitz GR, et al. Endovascular treatment of spontaneous dissections of the superior mesenteric artery. Journal of vascular surgery. 2009;50(6):1326-32.
Takahashi B, Nakayama Y, Shiroma S, Ido K. Three Case Report of Spontaneous Isolated Dissection of the Superior Mesenteric Artery—With an Algorithm Proposed for the Management. Annals of vascular diseases. 2015;8(2):120.
- Abstract Viewed: 274 times
- PDF Downloaded: 139 times
- HTML Downloaded: 70 times
