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Case Report

Turk J Vasc Surg. 2020; 29(3): 196-9

Type 3 intestinal failure after bypass grafting for isolated acute superior mesenteric artery dissection: A case report

Ahmed Elshiekh, Nick M Matharu.


Isolated superior mesenteric artery (SMA) dissection is a very rare cause of mesenteric ischemia. A 66-year-old male patient was admitted to
our emergency department with severe epigastric pain. He was diagnosed with spontaneous SMA dissection leading to intestinal ischemia.
A bypass graft was used to relieve acute ischemia with an initial success. However, this success was not sustained, as the graft failed
slowly despite a satisfactory technical appearance, leading to type 3 intestinal failure which could be explained by the competitive flow. In
conclusion, bypass grafting may yield short-term bowel viability in the treatment of isolated SMA dissection and acute ischemia; however,
grafts may fail without radiologically apparent technical complications possibly due to the competitive flow from the collateralizing circuits

Key words: Intestinal failure, mesenteric bypass, mesenteric ischemia, superior mesenteric artery dissection.

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