scholarly journals Acute superior mesenteric artery occlusion associated with COVID-19 pneumonia: a case report

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Masahiro Sukegawa ◽  
Satoshi Nishiwada ◽  
Taichi Terai ◽  
Hiroyuki Kuge ◽  
Fumikazu Koyama ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Transverse Colon ◽  
Social Life ◽  
Mesenteric Artery ◽  
Lower Lobe ◽  
Severe Abdominal Pain ◽  
Polymerase Chain Reaction Test ◽  
Renal Infarction ◽  
Mucous Fistula

Abstract Background The novel 2019 coronavirus disease (COVID-19), which is caused by infection with the severe acute respiratory syndrome coronavirus 2, has spread rapidly around the world and has caused many deaths. COVID-19 involves a systemic hypercoagulable state and arterial/venous thrombosis which induces unfavorable prognosis. Herein, we present a first case in East Asia where an acute superior mesenteric artery (SMA) occlusion associated with COVID-19 pneumonia was successfully treated by surgical intervention. Case presentation A 70-year-old man presented to his local physician with a 3-day history of cough and diarrhea. A real-time reverse transcriptase-polymerase chain reaction test showed positive for COVID-19, and he was admitted to the source hospital with the diagnosis of moderate COVID-19 pneumonia. Eight days later, acute onset of severe abdominal pain appeared with worsening respiratory condition. Contrast CT showed that bilateral lower lobe/middle lobe and lingula ground glass opacification with distribution suggestive of COVID-19 pneumonia and right renal infarction. In addition, it demonstrated SMA occlusion with intestinal ischemia suggesting extensive necrosis from the jejunum to the transverse colon. The patient underwent an emergency exploratory laparotomy with implementing institutional COVID-19 precaution guideline. Upon exploration, the intestine from jejunum at 100 cm from Treitz ligament to middle of transverse colon appeared necrotic. Necrotic bowel resection was performed with constructing jejunostomy and transverse colon mucous fistula. We performed second surgery to close the jejunostomy and transverse colon mucous fistula with end-to-end anastomosis on postoperative day 22. The postoperative course was uneventful and he moved to another hospital for rehabilitation to improve activities of daily living (ADLs) on postoperative day 45. As of 6 months after the surgery, his ADLs have completely improved and he has returned to social life without any intravenous nutritional supports. Conclusions Intensive treatment including surgical procedures allowed the patient with SMA occlusion in COVID-19 pneumonia to return to social life with completely independent ADLs. Although treatment for COVID-19 involves many challenges, including securing medical resources and controlling the spread of infection, when severe abdominal pain occurs in patients with COVID-19, physicians should consider SMA occlusion and treat promptly for life-saving from this deadly combination.

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.

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.

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

scholarly journals Carbon nanoparticles for identification of metastatic lymph nodes around the superior mesenteric artery in transverse colon cancer

2020 ◽  
Author(s):  
YuXin Xu ◽  
Pan Chi ◽  
Ying Huang ◽  
XiaoJie Wang ◽  
DaoXiong Ye
Keyword(s):  
Colon Cancer ◽  
Lymph Nodes ◽  
Superior Mesenteric Artery ◽  
Transverse Colon ◽  
Mesenteric Artery ◽  
Carbon Nanoparticles ◽  
Transverse Colon Cancer ◽  
Carbon Nanoparticle ◽  
Metastatic Lymph Nodes ◽  
Positive Station

Abstract Background Accurate identification of metastatic lymph nodes around the superior mesenteric artery (SMA), with or without metastasis, is vital for surgeons when dissecting lymph nodes in patients with transverse colon cancer. In the current study, we evaluated the prospect of using carbon nanoparticles in identification of lymph nodes around SMA. Methods We recruited a total of 220 patients, with transverse colon cancer, and divided them into two groups. The first group (n=51) was carbon nanoparticle (CN) while the other (n=169) had no carbon nanoparticle (NCN) group. Intraoperative and post-operative data were compared between the groups. Results We found that 117 patients were negative for D1 lymph nodes, while 3.4% were positive for D2 lymph nodes. Additionally, 169 patients were negative for D2 lymph nodes while 10.7% of patients were positive for D3 lymph nodes. Laparoscopy easily identified black-dyed lymph nodes in the CN group. Significantly higher numbers of positive station D3 lymph nodes (0.63 ± 2.43 vs 0.29 ± 1.03, p = 0.006), number of positive station 214 nodes (0.10 ± 0.13 vs 0.08 ± 0.17, p = 0.004), the number of positive lymph nodes (2.69 ± 5.38 vs 1.90 ± 4.22, p = 0.037), and the number of total lymph nodes (39.67 ± 19.33 vs 34.50 ± 18.99, p = 0.037) were found in the CN compared to NCN group. However, we found no significant differences between CN and NCN groups with regards to the number of positive station D1 and D2 lymph nodes. Conclusions We successfully identified metastases 214 LNs around SMA in transverse colon cancer using carbon nanoparticles. These particles have potential to significantly increase the number of positive and negative lymph nodes.

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.

Sign in / Sign up

Export Citation Format

Share Document