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Case report
Segmental arterial mediolysis: a commonly overlooked aetiology of acute abdominal pain
  1. Moni Roy1,2,
  2. Ashish Kumar Roy2 and
  3. Mary E McCrate3,4
  1. 1Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA
  2. 2Department of Internal Medicine, OSF Saint Francis Medical Center, Peoria, Illinois, USA
  3. 3Department of Radiology, University Of Illinois College Of Medicine, Peoria, Illinois, USA
  4. 4Central Illinois Radiological Associates, Inc, Peoria, Illinois, USA
  1. Correspondence to Dr Moni Roy; moniroy27{at}


Segmental arterial mediolysis (SAM) is an uncommon condition and commonly missed diagnostic aetiology of acute abdominal pain, initially described in 1976. SAM is a non-inflammatory, non-atherosclerotic vasculopathy mostly involving the abdominal arteries with notable asymmetric involvement of the walls of the mesenteric arteries and their branches. Clinical presentation ranges from postprandial abdominal discomfort suggestive of mesenteric ischaemia to intra-abdominal bleeding. Pathophysiological explanation and prognosis of these cases are not well understood and therefore no clear guidelines for management exist. In this case report, we emphasise the imaging modalities used to reach the diagnosis and the management options available.

  • radiology
  • general practice / family medicine

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  • Contributors MR wrote the initial manuscript, performed study design. AKR and MEM reviewed the initial manuscript and edited it. MR and AKR performed data collection. MEM performed image collection and editing. All authors revised and edited the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.