Shimane Journal of Medical Science

Shimane Journal of Medical Science 34 1
2017-07-31 発行

Isolated Celiac Artery Dissection Caused by Segmental Arterial Mediolysis: A Case Report

中村 秋穂 卒後臨床研修センター
瀧波 慶和 救急医学講座
小谷 暢啓 救急医学講座
仁科 雅良 救急医学講座
下条 芳秀 Acute Care Surgery講座
比良 英司 Acute Care Surgery講座
渡部 広明 Acute Care Surgery講座
吉田 理佳 放射線医学講座
安藤 慎司 放射線医学講座
We encountered a case of intraabdominal hemorrhage caused by celiac artery dissection in a 74-year-old man. Angiography revealed the characteristic string-of-beads sign, irregular alternating arterial dilatations and stenoses giving a rosary-like appearance, which we suspected was caused by segmental arterial mediolysis (SAM) in the branches of the superior mesenteric artery (SMA); these findings were observed in two locations along the pancreaticoduodenal artery and at one point along the small gastric branch. The patient was managed conservatively and the splanchnic arterial aneurysm believed to be the origin of the hemorrhage, as well as the aneurysm along the small gastric branch, resolved. There are no established criteria for invasive treatment of splanchnic artery aneurysms but this case suggests that thorough follow-up is necessary in cases of SAM.