A case report of segmental arterial mediolysis in which computed tomography angiography was useful for diagnosis Report as inadecuate




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Clinical Journal of Gastroenterology

, Volume 6, Issue 6, pp 447–453

First Online: 06 November 2013Received: 18 July 2013Accepted: 12 October 2013

Abstract

A 48-year-old male presented to our hospital with abdominal pain. Laboratory studies showed no abnormality, the severity of his abdominal pain decreased, and the patient was discharged. Five days later, the patient visited a neighborhood clinic because of fever with a 3-day history of temperatures of approximately 38 °C. The patient was admitted to our hospital 6 days after his initial visit. Laboratory investigation revealed a C-reactive protein level of 18.2 mg-dL. Abdominal computed tomography CT showed an 80 × 60 mm hematoma behind the descending colon, but no extravasation was detected. Thin-slice maximum-intensity-projection images from CT angiography CTA showed irregular narrowing and intermittent fusiform dilatations of the left colonic artery, suggesting a vascular disease, such as segmental arterial mediolysis SAM. Digital subtraction angiography showed local irregularity, and ‘beading and narrowing’ of the left colonic artery, similar to the findings on CTA. Left hemicolectomy was electively performed on the twenty-fifth hospital day. Histological findings were consistent with SAM. Thus, CTA was a useful modality for the early diagnosis of SAM.

KeywordsSegmental arterial mediolysis Maximum-intensity-projection MIP images CT angiography CTA Digital subtraction angiography DSA  Download fulltext PDF



Author: Haruka Yoshida - Katsuaki Ukai - Mikako Sugimura - Hiromichi Akoshima - Kenji Kimura - Masahiro Iwabuchi - Keiichi Tadokoro

Source: https://link.springer.com/







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