OBJECTIVES The aim of this study was to evaluate the clinical course and vascular remodeling of spontaneous isolated intramural hematoma of the superior mesenteric artery (SIHSMA) after treatment. METHODS In this retrospective study, 24 consecutive patients with SIHSMA admitted from January 2009 through December 2016 were included in this study. The clinical characteristics, type and location of the dissection, clinical outcome and vascular remodeling were analyzed retrospectively. RESULTS The subjects included 21 men and three women, with a mean age of 50.58 years. The chief complaint was abdominal pain in all patients. The mean follow-up was 10.08 months. Among the 24 patients examined, two patients (8.33%) showed no obvious changes in the CT. Twenty patients were treated by conservative strategy. One case underwent exploratory laparotomy along with embolectomy and arteriotomy. Another three cases received angioplasty and stent implanting. Complete and partial remodeling was observed in 15 (62.5%) and four patients (16.67%). Three (12.5%) of the lesions had dissection remodeling and aneurysm change. CONCLUSIONS SIHSMA represented variable vascular remodeling, while most of the patient got a complete resolution during follow-up, and its clinical course was benign in this study. Vast majority of patients can be managed conservatively when there are no signs indicating organ ischemia.

中文翻译：

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肠系膜上动脉自发性孤立壁内血肿的临床和CT血管造影随访结果。

目的本研究的目的是评估治疗后自发性肠系膜上动脉（SIHSMA）自发性分离壁内血肿的临床病程和血管重塑。方法在这项回顾性研究中，纳入了2009年1月至2016年12月连续入院的24例SIHSMA患者。回顾性分析其临床特征，解剖类型和位置，临床结局和血管重塑。结果受试者包括21名男性和3名女性，平均年龄为50.58岁。主要的抱怨是所有患者的腹痛。平均随访时间为10.08个月。在检查的24例患者中，有2例（8.33％）的CT没有明显改变。20例患者采用保守策略治疗。1例患者行探查性剖腹术，栓子切除术和动脉切开术。另外三例接受了血管成形术和支架植入。在15名（62.5％）和4名患者（16.67％）中观察到完全和部分重塑。其中三个（12.5％）病变具有解剖重塑和动脉瘤改变。结论SIHSMA代表可变的血管重塑，而大多数患者在随访过程中获得了完全的消退，其临床过程在本研究中是良性的。当没有迹象表明器官缺血时，可以对大多数患者进行保守治疗。结论SIHSMA代表可变的血管重塑，而大多数患者在随访过程中获得了完全的消退，其临床过程在本研究中是良性的。当没有迹象表明器官缺血时，绝大多数患者可以保守治疗。结论SIHSMA代表可变的血管重塑，而大多数患者在随访过程中获得了完全的消退，其临床过程在本研究中是良性的。当没有迹象表明器官缺血时，绝大多数患者可以保守治疗。