Superior mesenteric arterial branch occlusion causing partial jejunal ischemia: a case report
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 leftlower 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-endanastomosis was performed. The diagnosis of segmental small bowel ischemia was confirmed by histopathological study.
Conclusion:
Mesenteric ischemia is a pathology well-known by surgeons, gastroenterologists and radiologists.
Acute and chronic mesenteric ischemia are two separate entities with theirown 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.
Author: Nele Van De WinkelAvine CheragwandiKoenraad NieboerFranciscus van TussenbroekKristel De VogelaereGeorges Delvaux
Credits/Source: Journal of Medical Case Reports 2012, 6:48
Published on: 2012-02-06
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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