Related Experiment Videos
Hyperhomocysteinemia presenting as superior mesenteric artery thrombosis
Thomas Alexander1, R Rajnish, R Balakrishnan
1Department of Gastroenterology, VSM Hospital, Mavelikara 690 103, Kerala. talex@sancharnet.in
Summary
A young man with acute abdomen had superior mesenteric artery thrombosis and intestinal gangrene due to high homocysteine levels. Treatment with folic acid normalized his homocysteine, leading to recovery and preventing recurrence in his brother.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Medical Genetics
Background:
- Superior mesenteric artery thrombosis is a rare but life-threatening condition.
- Hyperhomocysteinemia is a known risk factor for arterial and venous thrombosis.
- Early diagnosis and intervention are crucial for patient survival.
Observation:
- A 23-year-old male presented with acute abdomen and was diagnosed with superior mesenteric artery thrombosis.
- The patient developed extensive intestinal gangrene and dry gangrene of the digits.
- Laboratory evaluation revealed marked hyperhomocysteinemia.
Findings:
- Surgical resection of the gangrenous bowel was performed.
- Homocysteine levels normalized following folic acid supplementation.
- The patient remained well at 1-year follow-up, and his asymptomatic brother with hyperhomocysteinemia also responded to folic acid.
Implications:
- This case highlights the critical role of hyperhomocysteinemia as a cause of mesenteric ischemia.
- Folic acid supplementation can effectively manage hyperhomocysteinemia and prevent thrombotic events.
- Screening for hyperhomocysteinemia should be considered in patients with unexplained arterial thrombosis.