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Journal of Zhejiang University SCIENCE B

ISSN 1673-1581(Print), 1862-1783(Online), Monthly

Isolated superior mesenteric artery rupture caused by abdominal trauma

Abstract: The superior mesenteric artery (SMA) is one of the visceral branches of the abdominal aorta. It has multiple branches to supply blood and nutrition to the intestinal segment, and these form an anastomosis with each other. SMA injuries are usually classified as major visceral artery injuries, and have an incidence of <1%. The clinical manifestations of patients with SMA injuries include intra-abdominal bleeding and peritoneal irritation. The compromised blood supply can lead to intestinal ischemia and perforation. These injuries are often not diagnosed in time and have significant mortality rates of 25%‍–‍68% due to the lack of specific features (Maithel et al., 2020). Not only that, but patients with less severe trauma or no visible damage on initial examination may still have clinically significant intra-abdominal injuries (Nishijima et al., 2012). Emergency departments often encounter multiple cases that require urgent diagnosis and treatment (Li et al., 2021; Zhang et al., 2021; Zhou et al., 2021), and therefore, it is imperative to diagnose and manage these rare injuries expeditiously.

Key words: Blunt abdominal mesenteric injury; Superior mesenteric artery injury; Super-selective embolization

Chinese Summary  <35> 腹部创伤导致的孤立性肠系膜上动脉破裂

王萍1,2,宋聪颖1,2,陆远强1,2
1浙江大学医学院附属第一医院急诊科,中国杭州市,310003
2浙江省增龄与理化损伤性疾病诊治研究重点实验室,中国杭州市,310003
概要:肠系膜损伤在腹部钝性伤中发生率较低,但具有较高的致命性,临床诊治常具有挑战性。当钝性肠系膜损伤合并其他脏器损伤时,患者的临床症状明显,往往可以得到及时的诊断和治疗。但孤立性肠系膜损伤患者,病情隐匿,易发生漏诊,不能得到及时的诊治,影响患者的预后。本篇病例报道描述了一例在钢筋撞击后,发生孤立性肠系膜上动脉破裂出血的罕见病例。经检索发现,既往文献中未出现类似报道。该病例报道提示临床医生应该及时认识到这一隐匿的危重状况,及时采取治疗,改善患者的预后。

关键词组:腹部钝性伤;肠系膜上动脉损伤;超选择性栓塞


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DOI:

10.1631/jzus.B2200288

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On-line Access:

2022-12-15

Received:

2022-05-20

Revision Accepted:

2022-08-30

Crosschecked:

2022-12-15

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