Published online Oct 26, 2019. doi: 10.12998/wjcc.v7.i20.3276
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
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.
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.
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.