Ou Yang CM, Yen YT, Chua CH, Wu CC, Chu KE, Hung TI. Spontaneous superior mesenteric artery dissection following upper gastrointestinal panendoscopy: A case report and literature review. World J Clin Cases 2019; 7(20): 3276-3281 [PMID: 31667179 DOI: 10.12998/wjcc.v7.i20.3276]
Corresponding Author of This Article
Tsung-I Hung, MD, Attending Doctor, Chief Doctor, Department of General Surgery, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wen-Chang Road, Shi-Lin, Taipei 111, Taiwan. e47817@yahoo.com.tw
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Chih-Ming Ou Yang, Tsung-I Hung, Department of General Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan
Yu-Tong Yen, Chai-Hock Chua, Department of Cardiovascular Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan
Chin-Chu Wu, Department of Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan
Kuan-En Chu, Department of Internal Medicine, Division of Gastroenterology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan
Author contributions: Ou Yang CM and Chua CH were the patient’s attending physicians; Ou Yang CM and Yen YT contributed to the study concept and design; Ou Yang CM and Hung TI performed literature search; Ou Yang CM and Chu KE performed data acquisition; Ou Yang CM and Wu CC analyzed the data, interpreted the results, and provided administrative/technical/material support; Ou Yang CM and Hung TI contributed to manuscript writing; Ou Yang CM critically revised and gave final approval of the manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016) and have prepared this report according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Tsung-I Hung, MD, Attending Doctor, Chief Doctor, Department of General Surgery, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wen-Chang Road, Shi-Lin, Taipei 111, Taiwan. e47817@yahoo.com.tw
Telephone: +88-62-28332211 Fax: +88-62-28389404
Received: April 17, 2019 Peer-review started: April 17, 2019 First decision: June 10, 2019 Revised: August 13, 2019 Accepted: August 27, 2019 Article in press: August 27, 2019 Published online: October 26, 2019 Processing time: 192 Days and 1.9 Hours
Abstract
BACKGROUND
Complications associated with upper gastrointestinal (UGI) endoscopy are uncommon, and rarely involve those of cardiovascular nature. We report herein a unique case of spontaneous superior mesenteric artery dissection (SMAD) after UGI pandenoscopy.
CASE SUMMARY
A 45-year-old man who had previously undergone UGI panendoscopy and colonoscopy during a voluntary health check-up at our facility was admitted to the emergency room (ER) at the same facility due to persistent epigastric pain with radiation to the back. At the ER, the patient did not present notable abnormalities upon physical, conscious, or laboratory examinations apart from mild tenderness in the epigastric abdomen. Acute abdominal aortic dissection was suspected, and abdominal contrast-enhanced computed tomography confirmed SMAD. He was then transferred to the cardiovascular ward and treated conservatively with fasting, prostaglandin E1, and aspirin. The patient recovered and returned home soon after, and was symptom-free 6 months after discharge from the facility.
CONCLUSION
SMAD after UGI panendoscopic procedure is a previously unreported complication. Awareness of this complication and associated sequela is warranted.
Core tip: Although upper gastrointestinal panendoscopy is relatively safe and complications are uncommon, we encountered herein a rare case of post-procedure spontaneous superior mesenteric artery dissection (SMAD) in a middle-aged man. After panendoscopy, the patient experienced abdominal pain extending to back immediately and persisting for two weeks. Upon examination, there were no obvious physical or laboratory signs of organ perforation and peritonitis. SMAD was suspected and confirmed by contrast-enhanced CT of the abdomen. While the patient recovered without sequelae after being treated conservatively in the cardiovascular ward, SMAD is a potentially lethal condition and awareness of its association with panendoscopy is warranted.
