HISTORY: A previously healthy 47-year-old man had suffered from intermittent subacute abdominal pain for six weeks. He had no significant past medical history except of smoking (30 pack years).

INVESTIGATIONS: Physical examination and laboratory tests were unremarkable. Sonography and endoscopy showed no pathological findings. Eventually contrast-enhanced computed tomography revealed dissection of the superior mesenteric artery and an additional angiography showed a false aneurysm.

TREATMENT AND COURSE: Because of the extended dissection thrombarterectomy was preferred to percutaneous stent placement. Five months later the patient was free of symptoms and continues to take 100 mg aspirin daily.

CONCLUSIONS: Although spontaneous visceral artery dissection is uncommon, awareness of this event is crucial for diagnosis and therapy to prevent hemorrhage and potential bowel infarction. This case highlights the importance of computed tomography in the work-up of nonspecific abdominal pain.