scholarly journals Superior mesenteric artery injury during laparoscopic radical nephrectomy

2018 ◽  
Vol 5 (3) ◽  
pp. 136-141
Author(s):  
E. A. Kruglov ◽  
A. I. Narkevich ◽  
A. I. Babich ◽  
Y. A. Pobedintseva ◽  
V. A. Kudlachev ◽  
...  

The authors present to your a en on a rare clinical case of complete intersec on of the superior mesenteric artery in laparoscopic radical nephrectomy. This complica on emerged in the process of learning the technique of laparoscopic radical nephrectomy, before reaching the “plateau” of the learning curve, in condi ons of poor vision and in the interposi on of tissues due to paratumorous infitiltra on. This type of injury has a high risk of total necrosis of the small intestine. However, due to the concerted ac ons of the surgical service and the readiness of surgeons to complete the vascular suture of the main vessels, a successful reimplanta on of the superior mesenteric artery into the aorta was performed. This is confi rmed by postopera ve observa on and examina on, which included CT angiography. It should be noted that descrip ons of cases of aor c reimplanta on of the superior mesenteric artery are extremely rare in the world and national literature, except for cases of mesenteric ischemia. This case contributes to the description of rare cases of aor c reimplanta on of the superior mesenteric artery and shows the correctness of the selected surgical tactics.

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.


1962 ◽  
Vol 08 (01) ◽  
pp. 096-100
Author(s):  
Marvin Murray ◽  
Robert Johnson

Summary133 blood vessels were evaluated for vasculokinase concentration in the freshly morbid state. High concentrations of activity were found in the aorta, iliac artery, superior mesenteric artery and popliteal artery. Activity was occasionally found in the inferior vena cava and common iliacs veins. Other vessels evaluated had no activity. Evaluation of the data with respect to vas-culokinase activity and atherosclerosis suggests higher levels of vasculokinase in those vessels having atherosclerosis.


1998 ◽  
Vol 38 (3) ◽  
pp. 441
Author(s):  
Young Lan Seo ◽  
Chul Soon Choi ◽  
Ho Chul Kim ◽  
Sang Hoon Bae ◽  
Eil Seong Lee ◽  
...  

2015 ◽  
Vol 18 (3) ◽  
pp. 088
Author(s):  
Ye-tao Li ◽  
Xiao-bin Liu ◽  
Tao Wang

<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>


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