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 ◽  
...  
2003 ◽  
Vol 10 (5) ◽  
pp. 1015-1018 ◽  
Author(s):  
Masashi Tsuda ◽  
Mamoru Nakamura ◽  
Yasuo Yamada ◽  
Haruo Saito ◽  
Tadashi Ishibashi ◽  
...  

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.


VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 495-498 ◽  
Author(s):  
Rajkovic ◽  
Zelic ◽  
Papes ◽  
Cizmek ◽  
Arslani

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.


2016 ◽  
Vol 43 (1) ◽  
pp. 91-93 ◽  
Author(s):  
Amol Raizada ◽  
Nachiket Apte ◽  
Scott Pham

Q fever is a zoonotic disease with a reservoir in mammals, birds, and ticks. Acute cases in human beings can be asymptomatic, or they can present with a flu-like illness, pneumonia, or hepatitis. Approximately 5% of cases progress to chronic Q fever. Endocarditis, the most typical manifestation of chronic Q fever, is usually associated with small vegetations that occur in patients who have had prior valvular damage or who are immunocompromised. We present what we think is the first reported case of superior mesenteric artery embolism from Q fever endocarditis of the aortic valve, in a 39-year-old woman who needed surgical embolectomy and subsequent aortic valve replacement.


2008 ◽  
Vol 69 (7) ◽  
pp. 1796-1799 ◽  
Author(s):  
Keitaro WATANABE ◽  
Hisashi TSUJI ◽  
Saki NAKAHARA ◽  
Kazunori TSUKUDA ◽  
Eiji IKEDA ◽  
...  

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