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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Superior mesenteric arterial branch occlusion causing partial jejunal ischemia: a case report
Nele Van De Winkel1, Avine Cheragwandi, Koenraad Nieboer
1Department of Abdominal Surgery, UZ Brussel, Vrije Universiteit Brusse, Brussels, Belgium. nele.vandewinkel@uzbrussel.be.
Journal of Medical Case Reports
|February 8, 2012
Summary
This case report details a rare instance of acute mesenteric ischemia caused by superior mesenteric artery occlusion, presenting with chronic symptoms. This highlights diagnostic challenges in ischemic bowel disease.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Radiology
Background:
- Ischemic bowel disease encompasses mesenteric and colonic ischemia, with distinct acute and chronic forms.
- Diagnosis can be challenging due to non-specific symptoms and subtle clinical signs.
- Mesenteric ischemia requires specific diagnostic and therapeutic approaches.
Purpose of the Study:
- To present a unique case of acute mesenteric ischemia with segmental superior mesenteric artery occlusion.
- To discuss the diagnostic difficulties and clinical presentation of this rare condition.
Main Methods:
- Case report of a 68-year-old woman with abdominal discomfort, melena, and fever.
- Diagnostic workup included CT abdomen, CT enterography, enteroscopy, angiography, and small bowel enteroclysis.
- Surgical resection of the ischemic jejunal segment with end-to-end anastomosis.
Main Results:
- Computed tomography and angiography revealed an ischemic jejunal segment due to superior mesenteric artery branch occlusion.
- Histopathological study confirmed segmental small bowel ischemia.
- The patient underwent successful surgical resection and anastomosis.
Conclusions:
- Acute and chronic mesenteric ischemia are distinct entities with unique presentations and management.
- This case represents the first reported instance of acute mesenteric ischemia due to segmental superior mesenteric artery occlusion.
- The patient's presentation mimicked chronic ischemia despite an acute etiology, underscoring diagnostic complexities.
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