Simultaneous Thromboembolism Of The Superior Mesenteric And Both Renal Arteries

Abstract

Thromboembolism of the peripheral circulation is relatively common but that of the visceral arteries is rare. We report a case of simultaneous atheroembolism of the superior mesenteric artery and both renal arteries from a left ventricular mural thrombus, six weeks following a myocardial infarction in a 79-year-old woman. Remarkably, the peripheral circulation was unaffected. This has not been reported before. The patient died from multi-organ dysfunction syndrome. Whilst, bilateral renal infarction was diagnosed on the CT scan, the infarction of the small bowel was revealed only at the post-mortem examination. This case illustrates that emboli from the heart can lodge in an unusual manner in the visceral circulation without affecting the peripheral circulation. A high index of suspicion is required to diagnose mesenteric ischaemia, especially when complicated by other intraabdominal pathologies like renal infarction.