On the afternoon of February 13, a representative from Gia Dinh People’s Hospital in Ho Chi Minh City announced that they had successfully treated a critical case of acute abdominal pain caused by an extremely rare condition, which could have led to widespread intestinal necrosis and even death.
The patient, Mr. Đ.T.L., 50 years old from Lam Ha District, Lam Dong Province, visited a private hospital in Ho Chi Minh City earlier this month with severe abdominal pain, bloody stools, and near unconsciousness.
After undergoing examinations and a CT scan of his abdomen, he was diagnosed with isolated superior mesenteric artery dissection, causing a blockage in a section of the artery supplying blood to the intestines (over 100mm long). This resulted in severe intestinal ischemia, which could progress to small bowel necrosis if not promptly addressed.
Due to the complexity and extent of the damage exceeding the initial hospital’s capacity, an emergency consultation was held with the interventional radiology team at Gia Dinh People’s Hospital. The patient was then transferred immediately for further specialized treatment.
At Gia Dinh People’s Hospital, Mr. L. underwent multidisciplinary consultations involving experts in interventional radiology, gastrointestinal surgery, cardiovascular intensive care, and anesthesiology.
Based on clinical symptoms, imaging findings, and emergency response experience, the doctors decided on an optimal treatment plan: placing a stent at the site of the dissection to fully restore blood flow through the superior mesenteric artery, preventing further ischemia and intestinal necrosis.
Dr. Lê Anh Huy, head of the Interventional Radiology Unit and the primary treating physician for Mr. L., shared that after the stent placement, the patient was closely monitored by specialists from the Gastrointestinal Surgery and Cardiovascular Intensive Care departments. If the endovascular intervention proved ineffective, surgical removal of the necrotic bowel segment would be performed promptly.
Fortunately, the stent placement in the over 100mm-long dissected artery segment was highly successful, alleviating Mr. L.’s abdominal pain almost immediately. In the Cardiovascular Intensive Care Unit, the patient received anticoagulant medication to prevent recurrent thrombosis and ensure the stent remained functional.
In the initial days, Mr. L. was provided nutrition intravenously and kept on a fasting regimen to monitor his intestinal condition. After nearly a week of treatment, the man resumed normal eating, no longer experienced abdominal pain, and stopped passing bloody stools.
Dr. Nguyễn Đình Luân, Head of the Interventional Radiology Unit and Deputy Head of the Diagnostic Imaging Department at Gia Dinh People’s Hospital, stated that isolated superior mesenteric artery dissection is a rare condition (affecting only 0.06% of the population) but is highly dangerous.
If not diagnosed and treated promptly, it can lead to acute intestinal ischemia, bowel necrosis, and death. Each year, Gia Dinh People’s Hospital handles 3-4 similar cases, most of which are referred from other hospitals.
Patients with superior mesenteric artery dissection often experience unexplained severe abdominal pain lasting several hours or days, accompanied by nausea, vomiting, diarrhea or constipation, bloating, and post-meal discomfort.
Therefore, anyone experiencing these symptoms should seek immediate medical attention for proper diagnosis and early treatment.
