{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:59:22Z","timestamp":1780981162344,"version":"3.54.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Isolated superior mesenteric artery dissecting aneurysm (ISMADA) is rare and may lead to fatal outcomes. This case report presents the surgical management of a patient with a giant ISMADA complicated by suspected impending rupture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 70-year-old man was admitted with a 2-year history of intermittent abdominal pain that had worsened over the preceding 2\u202fdays. Examination revealed a 5\u202f\u00d7\u202f5\u202fcm pulsatile periumbilical mass with tenderness and mild lower abdominal tenderness with questionable rebound. Computed tomography angiography showed a 4.8\u202fcm isolated superior mesenteric artery dissecting aneurysm involving distal branches, with severe true lumen compression. Laboratory tests showed mild leukocytosis. Emergency resection of the aneurysm with prosthetic graft reconstruction of the superior mesenteric artery was performed in a hybrid operating room. Postoperative angiography confirmed graft patency. The patient resumed oral intake on postoperative day 4 and was discharged uneventfully on day 8. At 30-month follow-up, he remained asymptomatic without abdominal or gastrointestinal complaints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although rare, isolated superior mesenteric artery dissection can progress to aneurysmal degeneration, rupture, and hemorrhage. Most uncomplicated ISMAD cases can be managed conservatively, and endovascular therapy is feasible in anatomically suitable patients; however, open surgical repair remains indispensable in selected complex cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1836483","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:30:35Z","timestamp":1780979435000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Giant dissecting aneurysm of the superior mesenteric artery with distal branch involvement and true lumen collapse: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Chuwen","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyuan","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiyang","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"17179","DOI":"10.3748\/wjg.v20.i45.17179","article-title":"Management of isolated superior mesenteric artery dissection","volume":"20","author":"Lv","year":"2014","journal-title":"World J Gastroenterol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1053\/ejvs.2002.1785","article-title":"Spontaneous isolated dissection of the superior mesenteric artery","volume":"25","author":"Javerliat","year":"2003","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1016\/j.ejvs.2020.08.010","article-title":"Management of symptomatic spontaneous isolated superior mesenteric artery dissection: a single Centre experience with mid term follow up","volume":"60","author":"Shi","year":"2020","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3400\/avd.ra.21-00055","article-title":"Isolated superior mesenteric artery dissection: a novel etiology and a review","volume":"15","author":"Eldine","year":"2022","journal-title":"Ann Vasc Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/j.jvs.2015.09.047","article-title":"Isolated superior mesenteric artery dissection in China","volume":"63","author":"Luan","year":"2016","journal-title":"J Vasc Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1070","DOI":"10.1016\/j.asjsur.2022.01.062","article-title":"Isolated superior mesenteric artery dissection in China: a systematic review and meta-analysis","volume":"45","author":"Hou","year":"2022","journal-title":"Asian J Surg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"107187","DOI":"10.1016\/j.cmpb.2022.107187","article-title":"The pathogenesis of superior mesenteric artery dissection: an in-depth study based on fluid-structure interaction and histology analysis","volume":"226","author":"Jia","year":"2022","journal-title":"Comput Methods Prog Biomed"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1002\/jgf2.232","article-title":"Isolated superior mesenteric artery dissection and median arcuate ligament syndrome","volume":"20","author":"Tsuchida","year":"2019","journal-title":"J Gen Family Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1186\/s40792-019-0758-7","article-title":"Laparoscopic treatment in a patient with median arcuate ligament syndrome identified at the onset of superior mesenteric artery dissection: a case report","volume":"5","author":"Okada","year":"2019","journal-title":"Surg Case Rep"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.ejvs.2025.06.010","article-title":"Editor's choice - 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