Synchronous celiac axis and superior mesenteric artery embolism

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 495-498 ◽  
Author(s):  
Rajkovic ◽  
Zelic ◽  
Papes ◽  
Cizmek ◽  
Arslani
Keyword(s):  
Atrial Fibrillation ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Abdominal Cavity ◽  
Celiac Axis ◽  
Contrast Administration ◽  
Artery Embolism

We present a case of combined celiac axis and superior mesenteric artery embolism in a 70-year-old patient that was examined in emergency department for atrial fibrillation and diffuse abdominal pain. Standard abdominal x-ray showed air in the portal vein. CT scan with contrast showed air in the lumen of the stomach and small intestine, bowel distension with wall thickening, and a free gallstone in the abdominal cavity. Massive embolism of both celiac axis and superior mesenteric artery was seen after contrast administration. On laparotomy, complete necrosis of the liver, spleen, stomach and small intestine was found. Gallbladder was gangrenous and perforated, and the gallstone had migrated into the abdominal cavity. We found free air that crackled on palpation of the veins of the gastric surface. The patient’s condition was incurable and she died of multiple organ failure a few hours after surgery. Acute visceral thromboembolism should always be excluded first if a combination of atrial fibrillation and abdominal pain exists. Determining the serum levels of d-dimers and lactate, combined with CT scan with contrast administration can, in most cases, confirm the diagnosis and lead to faster surgical intervention. It is crucial to act early on clinical suspicion and not to wait for the development of hard evidence.

Acute Superior Mesenteric Artery Embolism: Rapid Reperfusion with Hydrodynamic Thrombectomy and Pharmacological Thrombolysis

2003 ◽  
Vol 10 (5) ◽  
pp. 1015-1018 ◽  
Author(s):  
Masashi Tsuda ◽  
Mamoru Nakamura ◽  
Yasuo Yamada ◽  
Haruo Saito ◽  
Tadashi Ishibashi ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Warfarin Therapy ◽  
Severe Abdominal Pain ◽  
Uneventful Recovery ◽  
Artery Embolism ◽  
Complete Restoration ◽  
Femoral Puncture ◽  
Hydrodynamic Thrombectomy

Purpose: To report a case of acute superior mesenteric artery (SMA) embolism successfully treated with hydrodynamic thrombectomy and pharmacological thrombolysis. Case Report: A 67-year-old man was admitted to the hospital with acute severe abdominal pain. Selective angiography via a femoral puncture revealed a complete embolic occlusion distal to the first jejunal branch of the SMA. Hydrodynamic thrombectomy resolved the severe abdominal pain of the patient in approximately 10 minutes after the start of thrombectomy. Local continuous thrombolysis with urokinase resulted in near complete restoration of the mesenteric flow after 24 hours. The patient made an uneventful recovery and continues to do well on warfarin therapy 8 months after treatment; he has shown no evidence of malabsorption. Conclusions: Although insertion of the device into the SMA via a femoral puncture is a difficult approach, we propose that hydrodynamic thrombectomy followed by local thrombolysis is a useful treatment for acute superior mesenteric artery embolism.

scholarly journals Spontaneous dissection of coeliac and superior mesenteric artery: double whammy

2021 ◽  
Vol 14 (3) ◽  
pp. e240047
Author(s):  
Kanhai Lalani ◽  
Tom Devasia ◽  
Ganesh Paramasivam
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Thrombus Formation ◽  
Hybrid Approach ◽  
Transluminal Angioplasty ◽  
Mesenteric Arteries ◽  
Visceral Artery ◽  
Bowel Rest

Isolated dissection of one of the mesenteric arteries without concurrent involvement of the aorta is a rare clinical entity and an unusual cause of abdominal pain. It usually involves one artery, most commonly the superior mesenteric artery (SMA) followed by the coeliac artery. We are reporting a rare case where both coeliac and SMA were showing dissection. We are reporting a case of 60-year-old hypertensive male who came with worsening abdominal pain for 5 days; CT scan showed coeliac and SMA dissection without any imaging evidence of intestinal ischaemia. He was successfully managed medically with bowel rest and anticoagulation. Two weeks of follow-up CT scan showed no progression or thrombus formation. For complicated cases, percutaneous transluminal angioplasty of a visceral artery or open surgical exploration or hybrid approach is required. However, for stable uncomplicated cases, medical therapy alone is sufficient.

scholarly journals Malrotation Induced Small Intestine Ischemia in an Adolescent

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Karadeniz Erdem ◽  
Atamanalp Selçuk Sabri
Keyword(s):  
Emergency Department ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Emergency Surgery ◽  
Mesenteric Artery ◽  
Duodenal Obstruction ◽  
Mesenteric Ischemia ◽  
Clockwise Rotation ◽  
Small Intestinal

Intestinal malrotation occurs if midgut does not complete or partially completes its 270° counter-clockwise rotation around the superior mesenteric artery during embryologic life. In general, it frequently manifests with vomiting due to duodenal obstruction and volvulus in the initial months of life, and it is very rare to manifest in the adulthood. A 20-year-old male patient who had severe abdominal pain, nausea, vomiting, and distention for one day was evaluated at the emergency department. On abdominal tomography “swirling appearance of structures around the superior mesenteric artery” was reported. CT appearance was considered compatible with a rotational anomaly. Emergency surgery was planned for the patient. In laparotomy, it was observed that an approximately 100 cm long small intestine segment was rotated around a band (Ladd) and ischemia was developed in this segment due to rotation of its mesentery. The rotation of the small intestinal mesentery was corrected by opening the bands. After the warm application to the intestinal mesenteric ischemia for a while, the color and the peristalsis of the intestines became normal. The patient was discharged on postoperative day 2 with suggestions.

scholarly journals A gastrointestinal stromal tumor: Case report

2002 ◽  
Vol 55 (9-10) ◽  
pp. 423-426
Author(s):  
Viktor Till ◽  
Matilda Djolai ◽  
Borut Pilipovic ◽  
Slavica Senicar ◽  
Ljiljana Hadnadjev ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Small Intestine ◽  
Case Report ◽  
Gastrointestinal Stromal Tumor ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Gastrointestinal Stromal Tumors ◽  
Abdominal Cavity ◽  
Stromal Tumor ◽  
Stromal Tumors

Introduction Gastrointestinal stromal tumors represent extremely rare tumors of the gastrointestinal system, especially when localized on the small intestine. Case report We report a case of a female patient, with recurrent gastrointestinal bleeding and severe anemia, caused by gastrointestinal stromal tumor of the small intestine. After negative endoscopic findings, she underwent radiological examination of the small intestine. Primary diagnostic radiological evaluation included: small intestine passage enteroclysis, computed tomography of the abdominal cavity and selective angiographic study of the three major aortic branches that supply the gastrointestinal tract in the abdomen (celiac axis, superior mesenteric artery and inferior mesenteric artery). Secondly, ultrasound of abdominal cavity was performed. Findings of small intestine passage and enteroclysis were negative. The tumor was visualized by computed tomography and ultrasound, but without distinctive anatomical localization in the abdominal cavity. Discussion The diagnostic dilemma has been resolved by using selective angiographic examination of celiac axis and superior mesenteric artery and thus a tumor formation was visualized in the mesenterium of the small intestine. Radiological findings were confirmed by surgery. Histopathological findings were positive for gastrointestinal stromal tumor. Conclusion Gastrointestinal stromal tumors of the small intestine rarely cause recurrent bleeding, but they should be included in differential diagnosis.

Antibiotic Therapy Did Not Prevent the Rupture of Mycotic Aneurysm of the Superior Mesenteric Artery

2015 ◽  
Vol 18 (3) ◽  
pp. 088
Author(s):  
Ye-tao Li ◽  
Xiao-bin Liu ◽  
Tao Wang
Keyword(s):  
Abdominal Pain ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Acute Abdominal Pain ◽  
Rare Complication ◽  
Emergency Operation ◽  
History Of

<p class="p1"><span class="s1">Mycotic aneurysm of the superior mesenteric artery (SMA) is a rare complication of infective endocarditis. We report a case with infective endocarditis involving the aortic valve complicated by multiple septic embolisms. The patient was treated with antibiotics for 6 weeks. During preparation for surgical treatment, the patient developed acute abdominal pain and was diagnosed with a ruptured SMA aneurysm, which was successfully treated with an emergency operation of aneurysm ligation. The aortic valve was replaced 17 days later and the patient recovered uneventfully. In conclusion, we present a rare case with infective endocarditis (IE) complicated by SMA aneurysm. Antibiotic treatment did not prevent the rupture of SMA aneurysm. Abdominal pain in a patient with a recent history of IE should be excluded with ruptured aneurysm.</span></p>

Doppler sonography of the superior mesenteric artery in children with recurrent abdominal pain

2008 ◽  
Vol 36 (6) ◽  
pp. 341-345 ◽  
Author(s):  
Asli Koktener ◽  
Ayse Esra Yilmaz ◽  
Ferat Catal ◽  
Sancar Eminoglu
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Doppler Sonography ◽  
Recurrent Abdominal Pain

Celiac Axis and Superior Mesenteric Artery: Danger Zone for Left Nephrectomy

2008 ◽  
Vol 22 (11) ◽  
pp. 2571-2574 ◽  
Author(s):  
Pierre Nevoux ◽  
Laurent Zini ◽  
Arnauld Villers ◽  
Emmanuel Boleslawski ◽  
Bertrand Nunes ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Celiac Axis ◽  
Danger Zone
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