Hepatic segmental arterial mediolysis: A case report and brief literature review

Author:

Pokharel Ashbina1,Karageorgiou Ioannis1,Shah Sangam2ORCID,Bhattarai Madhur2ORCID,Acharya Indira3,Bateman Judith4

Affiliation:

1. Department of Internal Medicine William Beaumont University Hospital Royal Oak Michigan USA

2. Tribhuwan University, Institute of Medicine Kathmandu Nepal

3. Department of Internal Medicine, Medstar Union Memorial Hospital Baltimore Maryland USA

4. Department of Rheumatology William Beaumont University Hospital Royal Oak Michigan USA

Abstract

Key Clinical messageWhen evaluating patients with abdominal pain, it is important to consider SAM in the differential diagnosis, along with vasculitis, fibromuscular dysplasia (FMD), atherosclerosis, mycotic aneurysms, and cystic medial degeneration.AbstractSegmental arterial mediolysis (SAM) is a rare arteriopathy which is an under‐recognized and commonly missed diagnosis of abdominal pain. We report a case of a 58‐year‐old female who presented with abdominal pain and was misdiagnosed with a urinary tract infection. The diagnosis was made with CTA and managed with embolization. Despite appropriate intervention and close hospital monitoring, further complications were inevitable. We conclude that though literature has shown better prognosis and even complete resolution after medical and/or surgical intervention, close follow up and monitoring is needed to avoid unexpected complications.

Publisher

Wiley

Subject

General Medicine

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