The superior mesenteric artery (SMA) is an uncommon location for spontaneous peripheral arterial dissections. In the past, most symptomatic SMA dissections were treated surgically. However, the authors recently treated a healthy 40-year-old man who experienced a symptomatic SMA dissection with anticoagulation therapy alone. The patient had bilateral internal carotid artery (ICA) dissections in the past that were also managed in a conservative fashion. To their knowledge, this is the first patient reported in the literature with both ICA and SMA dissections. In addition, he is one of only a few patients with an SMA dissection who was successfully treated without surgical intervention. From our experience with this patient and a review of the literature, we believe that a trial of anticoagulation therapy is warranted in all patients with uncomplicated, symptomatic SMA dissections.
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