A Rare Presentation of SMA Vasculitis with Chest and Upper Back Pain: Case Report

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A Rare Presentation of SMA Vasculitis with Chest and Upper Back Pain: Case Report

Amrit Narwan1, Adam Sauer1, Tanya Talwar1, Olivia Willes1, Nalin Ranasinghe2, Leonard Ranasinghe3*
1Medical students, California Northstate University College of Medicine, California, USA
2Director of Emergency Department, A.O. Fox Hospital, New York, USA
3Professor of Medical Education and Clerkship Director of Emergency Medicine, California Northstate University College of Medicine, California, USA

Corresponding Author: Leonard Ranasinghe, MD
Address: College of Medicine, California Northstate University, 9700 West Taron Drive, Elk Grove, California 95757, USA.
Received date: 01 July 2022; Accepted date: 18 July 2022; Published date: 25 July 2022

Citation: Narwan A, Sauer A, Talwar T, Willes O, Ranasinghe N, Ranasinghe L. A Rare Presentation of SMA Vasculitis with Chest and Upper Back Pain: Case Report. Asp Biomed Clin Case Rep. 2022 Jul 25;5(2):79-83.

Copyright © 2022 Narwan A, Sauer A, Talwar T, Willes O, Ranasinghe N, Ranasinghe L. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.

Keywords: Superior Mesenteric Artery, Mesenteric Ischemia, COVID-19, SMA Vasculitis, Case Report

Abstract

Mesenteric ischemia is a phenomenon that occurs when arteries supplying the gastrointestinal tract either become narrowed or obstructed, thus reducing or halting downstream perfusion. This case study will explore a case of mesenteric ischemia caused by SMA vasculitis, a nonatherosclerotic abdominal arterial vasculopathy (NAV), in which a 57 y/o woman with history of hyperlipidemia and GERD presented to the ER with chest and upper back pain. Initial work up for MI and PE were inconclusive and the patient was discharged. Patient then returned the next day complaining of chest and additional abdominal pain radiating to her back. An abdominal CTA, venous ultrasound, and MRI revealed findings highly suggestive of ischemia caused by vasculitis of the superior mesenteric artery, for which the patient was treated with tapering prednisone. Evaluation for mesenteric ischemia in patients presenting with nonspecific trunk pain will allow physicians to provide more prompt and catered care. Additionally, with the ubiquity of COVID-19 and its role in downstream inflammatory processes, atypical causes of mesenteric ischemia may be an increasingly important differential to consider.