Clinical and CT Angiographic Follow-Up Outcome of Spontaneous Isolated Intramural Hematoma of the Superior Mesenteric Artery

  • Z. Xiaoq
  • M. Hao
  • L. Lin
  • Y. Jiao
  • J. Zou
  • X. Zhang
  • Y. Y. HongEmail author
Clinical Investigation Arterial Interventions
Part of the following topical collections:
  1. Arterial Interventions



The aim of this study was to evaluate the clinical course and vascular remodeling of spontaneous isolated intramural hematoma of the superior mesenteric artery (SIHSMA) after treatment.


In this retrospective study, 24 consecutive patients with SIHSMA admitted from January 2009 through December 2016 were included in this study. The clinical characteristics, type and location of the dissection, clinical outcome and vascular remodeling were analyzed retrospectively.


The subjects included 21 men and three women, with a mean age of 50.58 years. The chief complaint was abdominal pain in all patients. The mean follow-up was 10.08 months. Among the 24 patients examined, two patients (8.33%) showed no obvious changes in the CT. Twenty patients were treated by conservative strategy. One case underwent exploratory laparotomy along with embolectomy and arteriotomy. Another three cases received angioplasty and stent implanting. Complete and partial remodeling was observed in 15 (62.5%) and four patients (16.67%). Three (12.5%) of the lesions had dissection remodeling and aneurysm change.


SIHSMA represented variable vascular remodeling, while most of the patient got a complete resolution during follow-up, and its clinical course was benign in this study. Vast majority of patients can be managed conservatively when there are no signs indicating organ ischemia.


Superior mesenteric artery Intramural hematoma Remodeling pattern Clinical course 



The authors thank ZHI (Nanjing Medical University, Jiangsu Province Hospital) for her collecting data.

Conflict of interest

The authors declare no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  • Z. Xiaoq
    • 1
  • M. Hao
    • 1
  • L. Lin
    • 1
  • Y. Jiao
    • 1
  • J. Zou
    • 1
  • X. Zhang
    • 1
  • Y. Y. Hong
    • 1
    Email author
  1. 1.Division of Vascular Surgery, Department of General SurgeryFirst Affiliated Hospital of Nanjing Medical UniversityNanjingPeople’s Republic of China

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