潟山 浩昭¹, 松元 淳¹, 伊瀬知 毅¹, 有馬 暉勝¹, 納 利一²

Hiroaki GATAYAMA¹, Jun MATSUMOTO¹, Tuyoshi ISECHI¹, Terukatsu ARIMA¹, Toshikazu OSAME²

¹鹿児島大学第2内科, ²ヲサメ内科クリニック

¹Second Department of Internal Medicine, Kagoshima University Faculty of Medicine, ²Osame Internal Medical Clinic

キーワード : Dissecting aneurysm, Superior mesenteric artery, Ultrasonography

The patient was a 59-year-old man with upper abdominal pain of sudden onset. Abdominal ultrasonography showed dilatation of the superior mesenteric artery (SMA)and a membranous hyperechoic lesion in its lumen. The true lumen of the SMA was stenotic. Color Doppler ultrasonography showed no flow signal in the false lumen. FFT analysis suggested patency of the SMA , and contrast-enhanced CT scan revealed a mural hematoma and intimal flap in it. A diagnosis of isolated dissecting aneurysm of the SMA was made, and the patient was treated conservatively and has since been followed up. Ultrasonographic examination conducted 4 months later showed the mural hematoma in the false lumen to have almost disappeared, and ultrasonographic examination of the SMA performed 14 months later showed no abnormal findings. Ultrasonography was useful for early diagnosis and folow up in this case of dissecting aneurysm.