CTICasesSegmental Arterial Medialysis (SAM)
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Imaging findings
Imaging of the upper abdomen reveals multiple areas of arterial disruption, short-segment dissections, and recanalization of prior intramural hematomas or dissections, involving branches of the superior mesenteric artery (SMA) and celiac artery. The thickening is eccentric and appears as intramural hematoma/dissection, rather than the circumferential thickening seen in vasculitis. Multiple areas of aneurysmal dilation are also present.
Key takeaways
Segmental Arterial Medialysis (SAM) is a rare non-inflammatory vasculopathy that can present with spontaneous dissections, aneurysms, and hematomas, particularly affecting the mesenteric vessels (celiac and SMA branches). The eccentric intramural hematoma/dissection pattern helps differentiate it from vasculitis.
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