患者男,61岁。因“上腹伴腰背部疼痛半天”入院,既往高血压病史。腹部彩超:距肠系膜上动脉起始段20mm以远肠系膜上动脉管壁增厚,呈实性等回声,最厚处约4.6mm,该处动脉外径9.2mm,局部管腔变细,内径约4.0 mm,累及长度约86mm,CDFI:局部血流变细,呈偏心,增厚管壁内未见血流信号显示。CTA:距肠系膜上动脉开口约18mm处可见破裂口,该处动脉管径约10mm,动脉壁内见对比剂充盈,壁内血栓长度约80 mm。胸、腹主动脉干及其他主要分支均未见夹层形成。诊断:孤立性肠系膜上动脉夹层(图1~2)。 Male patient, 61 years old. Because of “upper abdomen with back pain half a day ” admission, history of previous hypertension. Abdominal ultrasonography: from the beginning of superior mesenteric artery 20mm above the superior mesenteric artery wall thickening was solid and other echoes, the thickest at about 4.6mm, where the arterial diameter 9.2mm, local lumen thinning, diameter about 4.0 mm, involving a length of about 86mm, CDFI: local blood flow thinner, eccentric, thickening of the wall showed no blood flow signal. CTA: It is about 18mm away from the superior mesenteric artery. The diameter of the artery is about 10mm. See the contrast agent filling in the artery wall. The wall thrombus length is about 80mm. Thoracic, abdominal aortic trunk and other major branches were no sandwich formation. Diagnosis: Isolated mesenteric artery dissection (Figure 1 ~ 2).