Abstract
Factor V Leiden (FVL) is an inherited condition that prolongs the clotting process; this subsequently places individuals at a higher risk of developing a thromboembolism. This case study will discuss a 41-year-old female who developed a superior mesenteric artery occlusion with subsequent small bowel ischaemia on a background of FVL. The discussion will illustrate the rarity of an arterial occlusion, the risk factors that are associated with an ischaemic small bowel, the implications of inheriting FVL and some of the associated social aspects of an ileostomy.
Highlights
This case is important due to the rarity of an arterial occlusion, the risk factors that place an individual at higher risk of developing such a diagnosis and because it exposes some of the potential implications for a sufferer’s quality of life
The prevalence of Factor V Leiden (FVL) is estimated to be 4–5 per cent of the general population; FVL only increases the chances of developing a venous thromboembolism if in conjunction with other associated risk factors[2,3]
It was later discovered that the initial ischaemia was potentially caused by a hydrophilic polymer emboli, thought to have been from the superior mesenteric artery graft stent placed in the United States
Summary
This case is important due to the rarity of an arterial occlusion, the risk factors that place an individual at higher risk of developing such a diagnosis and because it exposes some of the potential implications for a sufferer’s quality of life. Because Jane remained otherwise clinically stable and improving, she was commenced on total parenteral nutrition (TPN) day six postoperatively and monitored closely for any further signs of deterioration. The 3PCT diagnosed an anastomotic leak and the vascular team remained confident that there was adequate collateral flow to supply the small bowel.
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