Segmental arterial mediolysis in splanchnic arteries: an uncommon cause of abdominal pain

Segmental arterial mediolysis is an uncommon arterial disease that primarily involves splanchnic arteries; abdominal pain is the most common clinical manifestation. We report the case of a 53-year-old male with postprandial diffuse abdominal pain of one month's standing. Physical examination was uneventful, and laboratory tests revealed no abnormal findings. Abdominopelvic CT/Angio-CT showed an increased caliber of the superior mesenteric artery resulting from eccentric circumferential wall thickening. The patent lumen had a segment with fusiform aneurysmal dilatation, 7 x 26 mm long. These vascular changes extended along a number of distal jejunal branches, which also presented complete lumen obliteration. Abdominal arteries were free from signs of arteriosclerotic disease. Findings were consistent with segmental arterial mediolysis.