Abstract
IntroductionIschemic bowel disease comprises both mesenteric ischemia and colonic ischemia. Mesenteric ischemia can be divided into acute and chronic ischemia. These are two separate entities, each with their specific clinical presentation and diagnostic and therapeutic modalities. However, diagnosis may be difficult due to the vague symptomatology and subtle signs.Case presentationWe report the case of a 68-year-old Caucasian woman who presented with abdominal discomfort, anorexia, melena and fever. A physical examination revealed left lower quadrant tenderness and an irregular pulse. Computed tomography of her abdomen as well as computed tomography enterography, enteroscopy, angiography and small bowel enteroclysis demonstrated an ischemic jejunal segment caused by occlusion of a branch of the superior mesenteric artery. The ischemic segment was resected and an end-to-end anastomosis was performed. The diagnosis of segmental small bowel ischemia was confirmed by histopathological study.ConclusionMesenteric ischemia is a pathology well-known by surgeons, gastroenterologists and radiologists. Acute and chronic mesenteric ischemia are two separate entities with their own specific clinical presentation, radiological signs and therapeutic modalities. We present the case of a patient with symptoms and signs of chronic mesenteric ischemia despite an acute etiology. To the best of our knowledge, this is the first report presenting a case of acute mesenteric ischemia with segmental superior mesenteric artery occlusion.
Highlights
Ischemic bowel disease comprises both mesenteric ischemia and colonic ischemia
Mesenteric ischemia is a pathology well-known by surgeons, gastroenterologists and radiologists
We present the case of a patient with symptoms and signs of chronic mesenteric ischemia despite an acute etiology
Summary
Mesenteric ischemia can be divided into acute and chronic ischemia, two separate entities, each with their own specific clinical presentation and diagnostic and therapeutic modalities. Diagnosis may be difficult due to the vague symptomatology and subtle physical signs. These diagnoses should always be kept in mind in any patient with chronic postprandial abdominal pain in whom no other diagnosis can be made. The diagnosis should be confirmed by angiography. Management of intestinal ischemia consists of blood flow restoration through medical treatment or surgical management, depending on the etiology. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have