Segmental arterial mediolysis (SAM) is a rare disorder of the arteries characterized by the development of aneurysms, blood clots, narrowing of the arteries (stenoses), and blood collections (hematomas) in the affected distribution.[1][2]
SAM most commonly affects the arteries supplying the intestines and abdominal organs.[citation needed]
Often Segmental Arterial Mediolysis is diagnosed after clinical presentation with symptoms as above followed by CT angiogram or MRI demonstrating aneurysm(s).[4] The gold standard method for confirming the diagnosis is surgical resection of the affected area of blood vessel followed by histologic investigation under a microscope.[3] Segmental Arterial Mediolysis must be differentiated from fibromuscular dysplasia, atherosclerosis, and other systemic vasculidites including polyarteritis nodosa, Takayasu's arteritis, Behcet's disease, cystic medial necrosis, and cystic adventitial artery disease.[4]
TreatmentEdit
Patients presenting with bleeding into the abdominal cavity require possible blood transfusions and emergent intervention with coil embolization via catheter angiography.[3] Patients without active bleeding, but diagnosed aneurysms should have strict blood pressure control with antihypertensive drugs to decrease the risk of aneurysm rupture.[3]
EpidemiologyEdit
Since it was first reported in 1976[5] there have been 101 documented cases of Segmental Arterial Mediolysis.[6] Although typically seen in older patients with an average age of 57 years old,[6] it can affect patients of any age and does not favor one gender or the other.[5]
ReferencesEdit
^Ko, M; Kamimura, K; Sakamaki, A; Niwa, Y; Tominaga, K; Mizuno, K; Terai, S (22 July 2019). "Rare Mesenteric Arterial Diseases: A Case Report of Fibromuscular Dysplasia and Segmental Arterial Mediolysis and Literature Review". Internal Medicine (Tokyo, Japan). 58 (23): 3393–3400. doi:10.2169/internalmedicine.3094-19. PMC6928505. PMID 31327836.
^Ko, M; Kamimura, K; Ogawa, K; Tominaga, K; Sakamaki, A; Kamimura, H; Abe, S; Mizuno, K; Terai, S (28 August 2018). "Diagnosis and management of fibromuscular dysplasia and segmental arterial mediolysis in gastroenterology field: A mini-review". World Journal of Gastroenterology. 24 (32): 3637–3649. doi:10.3748/wjg.v24.i32.3637. PMC6113722. PMID 30166859.
^ abcdTan, Rebekah (2019-09-30). "Segmental Arterial Mediolysis: A Case Study and Review of the Literature in Accurate Diagnosis and Management". Vascular Specialist International. 35 (3): 174–179. doi:10.5758/vsi.2019.35.3.174. ISSN 2288-7970. PMC6774432. PMID 31620405.
^ abKim, Hyun Soo; Min, Sang-il; Han, Ahram; Choi, Chanjoong; Min, Seung-Kee; Ha, Jongwon (2016-08-11). "Longitudinal Evaluation of Segmental Arterial Mediolysis in Splanchnic Arteries: Case Series and Systematic Review". PLOS ONE. 11 (8): e0161182. Bibcode:2016PLoSO..1161182K. doi:10.1371/journal.pone.0161182. ISSN 1932-6203. PMC4981304. PMID 27513466.
October 21, 2023
segmental, arterial, mediolysis, rare, disorder, arteries, characterized, development, aneurysms, blood, clots, narrowing, arteries, stenoses, blood, collections, hematomas, affected, distribution, most, commonly, affects, arteries, supplying, intestines, abdo. Segmental arterial mediolysis SAM is a rare disorder of the arteries characterized by the development of aneurysms blood clots narrowing of the arteries stenoses and blood collections hematomas in the affected distribution 1 2 SAM most commonly affects the arteries supplying the intestines and abdominal organs citation needed Contents 1 Signs and Symptoms 2 Mechanism 3 Diagnosis 4 Treatment 5 Epidemiology 6 ReferencesSigns and Symptoms EditVaries depending on the location of the affected blood vessels Gastrointestinal System 3 Acute abdominal pain most common 4 Flank pain Nausea Vomiting Diarrhea Bloody stools Back painNervous System 3 Headache StrokeThe most severe signs occur if an aneurysm ruptures potentially resulting in 4 Shock Loss of consciousness Bleeding into the abdominal cavity Bleeding into the brainMechanism EditThe middle layer of an artery called the media made of smooth muscle is damaged 3 Mediolysis occurs when the smooth muscle cells in the area of damage are destroyed 3 Small gaps are formed in the wall of the artery which then fill with blood 3 Gaps create weakness in the wall of the artery allowing increasing pressure from blood to expand the gaps resulting in an aneurysm 3 Aneurysms have potential for rupture 3 Diagnosis EditOften Segmental Arterial Mediolysis is diagnosed after clinical presentation with symptoms as above followed by CT angiogram or MRI demonstrating aneurysm s 4 The gold standard method for confirming the diagnosis is surgical resection of the affected area of blood vessel followed by histologic investigation under a microscope 3 Segmental Arterial Mediolysis must be differentiated from fibromuscular dysplasia atherosclerosis and other systemic vasculidites including polyarteritis nodosa Takayasu s arteritis Behcet s disease cystic medial necrosis and cystic adventitial artery disease 4 Treatment EditPatients presenting with bleeding into the abdominal cavity require possible blood transfusions and emergent intervention with coil embolization via catheter angiography 3 Patients without active bleeding but diagnosed aneurysms should have strict blood pressure control with antihypertensive drugs to decrease the risk of aneurysm rupture 3 Epidemiology EditSince it was first reported in 1976 5 there have been 101 documented cases of Segmental Arterial Mediolysis 6 Although typically seen in older patients with an average age of 57 years old 6 it can affect patients of any age and does not favor one gender or the other 5 References Edit Ko M Kamimura K Sakamaki A Niwa Y Tominaga K Mizuno K Terai S 22 July 2019 Rare Mesenteric Arterial Diseases A Case Report of Fibromuscular Dysplasia and Segmental Arterial Mediolysis and Literature Review Internal Medicine Tokyo Japan 58 23 3393 3400 doi 10 2169 internalmedicine 3094 19 PMC 6928505 PMID 31327836 Ko M Kamimura K Ogawa K Tominaga K Sakamaki A Kamimura H Abe S Mizuno K Terai S 28 August 2018 Diagnosis and management of fibromuscular dysplasia and segmental arterial mediolysis in gastroenterology field A mini review World Journal of Gastroenterology 24 32 3637 3649 doi 10 3748 wjg v24 i32 3637 PMC 6113722 PMID 30166859 a b c d e f g h i j Pillai Anil Kumar Iqbal Shams I Liu Raymond W Rachamreddy Niranjan Kalva Sanjeeva P 2014 02 20 Segmental Arterial Mediolysis CardioVascular and Interventional Radiology 37 3 604 612 doi 10 1007 s00270 014 0859 4 ISSN 0174 1551 PMID 24554198 S2CID 260870849 a b c d Tan Rebekah 2019 09 30 Segmental Arterial Mediolysis A Case Study and Review of the Literature in Accurate Diagnosis and Management Vascular Specialist International 35 3 174 179 doi 10 5758 vsi 2019 35 3 174 ISSN 2288 7970 PMC 6774432 PMID 31620405 a b Ko Masayoshi Kamimura Kenya Sakamaki Akira Niwa Yusuke Tominaga Kentaro Mizuno Kenichi Terai Shuji 2019 12 01 Rare Mesenteric Arterial Diseases Fibromuscular Dysplasia and Segmental Arterial Mediolysis and Literature Review Internal Medicine 58 23 3393 3400 doi 10 2169 internalmedicine 3094 19 ISSN 0918 2918 PMC 6928505 PMID 31327836 a b Kim Hyun Soo Min Sang il Han Ahram Choi Chanjoong Min Seung Kee Ha Jongwon 2016 08 11 Longitudinal Evaluation of Segmental Arterial Mediolysis in Splanchnic Arteries Case Series and Systematic Review PLOS ONE 11 8 e0161182 Bibcode 2016PLoSO 1161182K doi 10 1371 journal pone 0161182 ISSN 1932 6203 PMC 4981304 PMID 27513466 Retrieved from https en wikipedia org w index php title Segmental arterial mediolysis amp oldid 1174283597, wikipedia, wiki, book, books, library,
