Ischemic Bowel Disease Due to Superior Mesenteric Artery Occlusion: A Case Report

Meng-Yu Wu,Yu-Long Chen,Yueh-Tseng Hou,Bo-Yang Ni,Giou-Teng Yiang,Yung-Chang Chien,Ling-Chi Lee

doi:10.3390/reports1010010

Abstract

Acute mesenteric infarction is a rare but emergency disease with a high mortality rate. The rapidly restoration of intestinal blood flow is the early goal of vascular intervention. However, the unspecific presentation may confuse physicians and delay a timely diagnosis. The rate of intestinal failure in survivors is still high. Here, we present the case of an 85-year-old male presenting with acute onset progressive periumbilical cramping pain with elevated D-dimer. The abdominal computed tomography (CT) revealed severe acute superior mesenteric artery occlusion. The surgical report showed a massively ischemic small intestine that was about 250 cm with 200 mL bloody ascites. We highlight that early diagnosis and timely intervention are important for improving outcomes.

Highlights

Acute mesenteric infarction is a rare but emergency disease with a high mortality rate
A multidisciplinary and multimodal management approach were proposed to increase the survival of acute mesenteric infarction patients
Acute mesenteric mesenteric infarction can be divided into acute mesenteric arterial embolism and thrombosis

Summary

Introduction

Acute mesenteric infarction is a rare but emergency disease with a high mortality rate. High rates of intestinal failure were reported in a large group of survivors [1]. The complications, such as sepsis and multiple organ failure, occurred with a high incidence in delayed diagnosis patients. The unspecific presentation may confuse physicians and delay timely diagnosis. The delayed or missed diagnosis may cause bowl necrosis, the progression of sepsis, and multiple organ failure. The abdominal CT revealed severe acute superior mesenteric artery occlusion. This paper discusses the clinical and image features of acute superior mesenteric artery occlusion and highlights the importance of early diagnosis and timely intervention for improving outcomes

Case Presentation Section

Findings

Discussion