Case Reports
27 September 2024
Vol. 18 No. 3 (2024)
Segmental arterial mediolysis: a challenging diagnosis in internal medicine
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
669
Views
254
Downloads
117
HTML
Authors
Segmental arterial mediolysis (SAM) is an uncommon, nonatherosclerotic, noninflammatory, large- to medium-sized arteriopathy first described in 1976, affecting splanchnic branches of the aorta. The clinical presentation ranges from asymptomatic to severe, life-threatening intra-abdominal hemorrhage and shock. A healthy 53-year-old woman with abdominal pain was referred to our facility for further management of superior mesenteric artery dissection diagnosed in the emergency room. A computed tomography scan revealed a dissection in both renal arteries, leading to ischemic degeneration in the left apical pole of the kidney. Additionally, three aneurysmatic dilatations, ectasia of intrahepatic vessels, and irregularities in the wall of the iliac arteries were identified. No other pathological lesions were observed. Based on imaging and the absence of inflammatory and autoimmune markers, a diagnosis of SAM was made. Since an endovascular intervention was excluded and both anticoagulation and antiplatelet therapy were initiated, the patient has undergone close clinical and radiological follow-up.
Altmetrics
Downloads
Download data is not yet available.
Citations
Peng KX, Davila VJ, Stone WM, et al. Natural history and management outcomes of segmental arterial mediolysis. J Vasc Surg 2019;70:1877-86. DOI: https://doi.org/10.1016/j.jvs.2019.02.068
Najmaoui M, Pezzulo M, Franchimont D, et al. Segmental arterial mediolysis and its mimickers: a case report and review of the literature. EJCRIM 2023;10:004085. DOI: https://doi.org/10.12890/2023_004085
Kennedy CA, Toomey DP. Segmental arterial mediolysis: a rare cause of an acute abdomen. J Surg Case Rep 2021;2021:rjab370. DOI: https://doi.org/10.1093/jscr/rjab370
Alavandar E, Umapathy S, Poyyamoli S, et al. Clinical presentation, imaging, and management of segmental arterial mediolysis: a rare vascular disorder. Indian J Radiol Imaging 2021;31:983-9. DOI: https://doi.org/10.1055/s-0041-1736583
Van Twist DJL, Appelboom Y, Magro-Checa C, et al. Differentiating between segmental arterial mediolysis and other arterial vasculopathies to establish an early diagnosis - a systematic literature review and proposal of new diagnostic criteria. Postgrad Med 2024;136:1-13. DOI: https://doi.org/10.1080/00325481.2023.2288561
Gornik HL, Persu A, Adlam D, et al. First international consensus on the diagnosis and management of fibromuscular dysplasia. Vasc Med 2019;24:164-89. DOI: https://doi.org/10.1177/1358863X18821816
Wolff L, Horisberger A, Moi L, et al. Polyarteritis nodosa: old disease, new etiologies. Int J Mol Sci 2023;24:16668. DOI: https://doi.org/10.3390/ijms242316668
Faivre L, Collod-Beroud G, Adès L, et al. The new Ghent criteria for Marfan syndrome: what do they change? Clin Genet 2012;81:433-42. DOI: https://doi.org/10.1111/j.1399-0004.2011.01703.x
Tan R. Segmental arterial mediolysis: a case study and review of the literature in accurate diagnosis and management. Vasc Specialist Int 2019;35:174-9. DOI: https://doi.org/10.5758/vsi.2019.35.3.174
Shimohira M, Kondo H, Ogawa Y, Kawada H, et al. Natural history of unruptured visceral artery aneurysms due to segmental arterial mediolysis and efficacy of transcatheter arterial embolization: a retrospective multiinstitutional study in Japan. AJR Am J Roentgenol 2021;216:691-7. DOI: https://doi.org/10.2214/AJR.19.22547
Srinivasan A, Olowofela A, Rothstein A, et al. A single center 8 year experience of segmental arterial mediolysis management. Ann Vasc Surg 2022;81:273-82. DOI: https://doi.org/10.1016/j.avsg.2021.09.045
Castelli F, Inì C, Scavone G, et al. Clinically suspected segmental arterial mediolysis of the splanchnic arteries: a report of 2 rare cases. Am J Case Rep 2021;22:e929013-1-8. DOI: https://doi.org/10.12659/AJCR.929013
Twine CP, Kakkos SK, Aboyans V, et al. Editor’s choice – European Society for Vascular Surgery (ESVS) 2023 clinical practice guidelines on antithrombotic therapy for vascular diseases. Eur J Vasc Endovasc Surg 2023;65:627-89. DOI: https://doi.org/10.1016/j.ejvs.2023.03.032
Naidu SG, Menias CO, Oklu R, et al. Segmental arterial mediolysis: abdominal imaging of and disease course in 111 patients. AJR Am J Roentgenol 2018;210:899-905. DOI: https://doi.org/10.2214/AJR.17.18309
Pokharel A, Karageorgiou I, Shah S, et al. Hepatic segmental arterial mediolysis: a case report and brief literature review. Clin Case Rep 2023;11:e7668. DOI: https://doi.org/10.1002/ccr3.7668
How to Cite
Segmental arterial mediolysis: a challenging diagnosis in internal medicine. (2024). Italian Journal of Medicine, 18(3). https://doi.org/10.4081/itjm.2024.1795
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Giuseppe Brunori, Aurelio Seidita, Lydia Giannitrapani, Antonietta Serruto, Francesco Bencivinni, Maurizio Soresi, An unusual Erdheim-Chester disease with orbital involvement: a case report , Italian Journal of Medicine: Vol. 11 No. 1 (2017)
- Andrea Calafiore, Fernando Rizzello, Chiara Praticò, Paolo Gionchetti, Carlo Calabrese, Giuseppina Liguori, Massimo Campieri, Clinical management of severe active ulcerative colitis in the TNF-a inhibitors era , Italian Journal of Medicine: Vol. 7 No. 4 (2013)
- Umberto Volta, Giacomo Caio, Francesco Tovoli, Roberto De Giorgio, Non-celiac gluten sensitivity: an emerging syndrome with many unsettled issues , Italian Journal of Medicine: Vol. 8 No. 4 (2014)
- Livia Robbiolo, Annalisa Carbone, Fabrizio Favales, Barbara Spelta, Fabrizio Colombo, Testing, testing, testing: an insidious hypereosinophilia , Italian Journal of Medicine: Vol. 3 No. 3 (2009)
- Chiara Benatti, Carla Sacchetti, Antonio Pedrazzi, Claudio Gollini, Federica Vecchi, Stefano Pederzoli, Marco Grandi, Eosinophilic gastroenteritis: a case report and a review of eosinophilic gastrointestinal disorders , Italian Journal of Medicine: Vol. 3 No. 3 (2009)
- Daniela Tirotta, Alessandro Franco, Francesca Talarico, Acute pancreatitis: confronting to improve , Italian Journal of Medicine: Vol. 11 No. 2 (2017)
- Pietro Crispino, Luca Fontanella, Paola Gnerre, Liver diseases and pregnancy , Italian Journal of Medicine: Vol. 11 No. 3 (2017)
- Elisa Eletto, Carmine Siniscalchi, Nicoletta Cerundolo, Beatrice Prati, Lorenzo Finardi, Riccardo Simoni, Alberto Parise, Antonio Nouvenne, Tiziana Meschi, A “cold” case of myxedema coma , Italian Journal of Medicine: Vol. 19 No. 2 (2025)
- Fábio Murteira, Pedro Oliveira, João Miranda, Albina Moreira, Margarida Correira, DRESS syndrome (drug rash with eosinophilia and systemic symptoms): sometimes, not all signs are there , Italian Journal of Medicine: Vol. 15 No. 3 (2021)
- Ernesto Cason, Giorgio Treglia, Paolo Orlandi, Giorgio Fagioli, The role of red blood cell scintigraphy in the multiple-modality imaging diagnosis of a rare case of diffuse hepatic hemangiomatosis in an adult , Italian Journal of Medicine: Vol. 5 No. 3 (2011)
You may also start an advanced similarity search for this article.