Superior mesenteric artery dissection with aneurysm, hematoma, and bowel ischemia mimicking pancreatitis: a rare case image report

Isolated SMA dissection with thrombosis, aneurysm, and hematoma can closely mimic acute pancreatitis, highlighting the importance of considering vascular causes in acute abdominal pain. Early use of contrast-enhanced CT guided by clinical red flags is crucial to prevent complications such as bowel necrosis. Our case demonstrates that, in hemodynamically stable patients, conservative management with supportive care, antihypertensives, and anticoagulation can result in favorable clinical and radiologic outcomes. This case demonstrates the integration of systematic CT imaging with clinical red-flag assessment to differentiate SMA dissections requiring urgent intervention from those amenable to conservative management, potentially reducing diagnostic delays and improving outcomes.