Minireviews
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2018; 24(32): 3637-3649
Published online Aug 28, 2018. doi: 10.3748/wjg.v24.i32.3637
Diagnosis and management of fibromuscular dysplasia and segmental arterial mediolysis in gastroenterology field: A mini-review
Masayoshi Ko, Kenya Kamimura, Kohei Ogawa, Kentaro Tominaga, Akira Sakamaki, Hiroteru Kamimura, Satoshi Abe, Kenichi Mizuno, Shuji Terai
Masayoshi Ko, Kenya Kamimura, Kohei Ogawa, Kentaro Tominaga, Akira Sakamaki, Hiroteru Kamimura, Satoshi Abe, Kenichi Mizuno, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 9518510, Japan
Author contributions: Ko M, Kamimura K wrote the manuscript; Ogawa K, Tominaga K, Sakamaki A, Kamimura H, Abe S, Mizuno K, and Terai S collected information; all authors read and approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare that they have no current financial arrangement or affiliation with any organization that may have a direct influence on their work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kenya Kamimura, MD, PhD, Lecturer, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata 9518510, Japan. kenya-k@med.niigata-u.ac.jp
Telephone: +81-25-2272207 Fax: +81-25-2270776
Received: May 25, 2018
Peer-review started: May 27, 2018
First decision: June 15, 2018
Revised: June 17, 2018
Accepted: June 25, 2018
Article in press: June 25, 2018
Published online: August 28, 2018
Abstract

The vascular diseases including aneurysm, occlusion, and thromboses in the mesenteric lesions could cause severe symptoms and appropriate diagnosis and treatment are essential for managing patients. With the development and improvement of imaging modalities, diagnostic frequency of these vascular diseases in abdominal lesions is increasing even with the small changes in the vasculatures. Among various vascular diseases, fibromuscular dysplasia (FMD) and segmental arterial mediolysis (SAM) are noninflammatory, nonatherosclerotic arterial diseases which need to be diagnosed urgently because these diseases could affect various organs and be lethal if the appropriate management is not provided. However, because FMD and SAM are rare, the cause, prevalence, clinical characteristics including the symptoms, findings in the imaging studies, pathological findings, management, and prognoses have not been systematically summarized. Therefore, there have been neither standard diagnostic criteria nor therapeutic methodologies established, to date. To systematically summarize the information and to compare these disease entities, we have summarized the characteristics of FMD and SAM in the gastroenterological regions by reviewing the cases reported thus far. The information summarized will be helpful for physicians treating these patients in an emergency care unit and for the differential diagnosis of other diseases showing severe abdominal pain.

Keywords: Fibromuscular dysplasia, Segmental arterial mediolysis, Mesenteric lesion, diagnosis, Humans

Core tip: The vascular diseases in the abdominal lesions needs to be appropriately diagnosed and treated as it could be lethal if the appropriate management is not provided. Mesenteric ischemia caused by the atherosclerotic changes is rather famous however, fibromuscular dysplasia (FMD) and segmental arterial mediolysis (SAM) which are noninflammatory, nonatherosclerotic arterial diseases are rare and the cause, prevalence, clinical characteristics including the symptoms, findings in the imaging studies, pathological findings, management, and prognoses have not been systematically summarized. Therefore, we have summarized the characteristics of FMD and SAM in the gastroenterological regions and review the cases reported thus far. The information summarized will be helpful for physicians treating these patients in an emergency care unit and for the differential diagnosis of other diseases showing severe abdominal pain.