ĐẶC ĐIỂM LÂM SÀNG VÀ HÌNH ẢNH CẮT LỚP VI TÍNH TRONG LÓC TÁCH ĐỘNG MẠCH MẠC TREO TRÀNG TRÊN ĐƠN ĐỘC

Abstract

Objective: To describe the clinical characteristics and computed tomography images of patients with isolated superior mesenteric artery dissection. Materials and methods: We retrospectively analyzed 50 patients with confirmed diagnoses of isolated superior mesenteric artery dissection with Computed tomography angiography from January 2020 to June 2024 at Hanoi Medical University Hospital. Results: The mean age was 61,8 ± 8,5, male to female ratio 9/1, 62% of patients have symptoms, the main symptoms are abdominal pain in the epigastric area and around the navel. 40% of tests had leukocytosis. 52% had increased diameter of the dissected artery segment, 38% had infiltration around the dissected artery segment, the average aortic-mesenteric angle was 72,8°±22,9, the average dissection length is 76,94±41,0 mm, classified according to Sakamoto type I accounting for 20%, type II accounts for 24%, type III accounts for 28%, type IV accounts for 28%, and 2% of cases have complications of intestinal ischemia. The symptomatic patients have a higher rate of infiltration around the dissected arterial segment (p= 0,002), showed longer dissection tendency (p=0,000) and more severe true lumen stenosis (p=0.006) compared with asymptomatic patients. There was a significantly different proportion of each type between symptomatic and asymptomatic patients (p = 0.0021). Conclusion: Isolated superior mesenteric artery dissection has non-specific clinical and laboratory characteristics, computed tomography is the best means to help confirm diagnosis and detect complications.