A rare case of acute type B aortic dissection involving superior mesenteric artery

Acute type B aortic dissection involving superior mesenteric artery hypoperfusion is a complicated kind B dissection, which is prone to intestinal ischemia and necrosis, and the mortality rate during hospitalization is high. The treatment of a rare patient with acute type B aortic dissection involving the superior mesenteric artery is described in this paper: The patient's dissection involved the superior mesenteric artery far away and the lesion was long, which made it difficult to undergo superior mesenteric artery stent implantation in the first stage. During the conservative treatment of aortic dissection in the hyperacute stage, the clinical symptoms and signs of the chest and abdomen improved significantly, and the combination of preoperative CT angiography (CTA) and intraoperative contrast showed the presence of a coarse compensatory Riolan arch, and the blood flow from the distal branch of superior mesenteric artery was good. Therefore, the patient did not treat the affected superior mesenteric artery at the same time after TEVAR, and the operation went smoothly. However, the patient had sudden abdominal pain and abdominal distension on the 5th day after surgery, and the CTA re-examination showed acute intestinal obstruction, and the condition of the superior mesenteric artery was similar to that before the interaction. Following MDT discussion in the hospital, he was discharged from the hospital after conservative treatment such as fasting water, gastrointestinal decompression, and nutritional support. CTA review a few months after surgery showed good remodeling of the superior mesenteric artery, and there were no adverse symptoms such as abdominal pain and chest pain.