Segmental Arterial Mediolysis: An Under-Recognized Cause of Chronic Abdominal Pain

  • Tulika Chatterjee Department of Internal Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA
  • Johnathon Stephens Department of Radiology, University of Illinois College of Medicine, Peoria, Illinois, USA
  • Moni Roy Department of Internal Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA; OSF Saint Francis Medical Center, Peoria, Illinois, USA
DOI: https://doi.org/10.12890/2020_001830

Keywords

segmental arterial mediolysis, chronic abdominal pain

Abstract

Segmental arterial mediolysis (SAM) is a non-inflammatory, non-atherosclerotic vasculopathy mostly involving the abdominal arteries. SAM was recently recognized as a more prevalent aetiology of abdominal pain than initially thought by healthcare providers. It is still a commonly missed diagnosis in patients with recurrent emergency room (ER) visits for abdominal pain. Most published case reports in the past have highlighted catastrophic sequelae such as intra-abdominal haemorrhage requiring surgical intervention. We report a case of SAM where the diagnosis was initially missed. After diagnosis, conservative medical management was offered which led to clinical improvement.

VIEW THE ENTIRE ARTICLE

References

  • Slavin RE, Gonzalez-Vitale JC. Segmental mediolytic arteritis: a clinical pathologic study. Lab Invest 1976;35(1):23–29.
  • Naidu SG, Menias CO, Oklu R, Hines RS, Alhalabi K, Makar G, et al. Segmental arterial mediolysis: abdominal imaging of and disease course in 111 patients.AJR Am J Roentgenol 2018;210:899–905.
  • Roy M, Roy AK, McCrate ME. Segmental arterial mediolysis: a commonly overlooked aetiology of acute abdominal pain. BMJ Case Rep 2020;13:e234576.
  • Kalva SP, Somarouthy B, Jaff MR, Wicky S. Segmental arterial mediolysis: clinical and imaging features at presentation and during follow-up. J Vasc Interv Radiol 2011;22(10):1380–1387.
  • Michael M, Widmer U, Wildermuth S, Barghorn A, Duewell S, Pfammatter T. Segmental arterial mediolysis: CTA findings at presentation and follow-up. AJR Am J Roentgenol 2006;187:1463–1469.

    • Published: 2020-07-27

    Issue: Vol 7 No 10 (view)

    Section: Articles

    How to cite:
    1.
    Chatterjee T, Stephens J, Roy M. Segmental Arterial Mediolysis: An Under-Recognized Cause of Chronic Abdominal Pain. EJCRIM 2020;7 doi:10.12890/2020_001830.

    Most read articles by the same author(s)