Background: Segmental medial arteriolysis (SAM) is a unique arteriopathy highlighted
by significant lytic changes in the medial wall of the blood vessels and can present from vague
gastrointestinal discomfort to catastrophic abdominal bleeding and shock. We hereby present a
concise review of this rare phenomenon with historic perspectives, epidemiology, and current
concepts of etiology, pathogenesis, relevant clinical associations, treatment modalities, prognosis
and future directions in SAM.
Conclusion: In addition, we present an interesting occurrence of this intriguing phenomenon in a
forty-eight year old lady at our institution who presented with vague symptomatology and was an
extremely challenging diagnosis. This highlights the importance of timely detection and institution
of therapeutic or preventive strategies to minimize future catastrophic events.