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Updated: Oct 11, 2025

Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Mesenteric and myocardial ischemia revealing lower limb sarcoma
1Department of Surgery, Inje University College of Medicine, Ilsan-Paik Hospital, Goyang, Republic of Korea.
Introduction And Importance:
Although most of the causes of acute superior mesenteric artery (SMA) embolism with a poor clinical course originate from the heart, we report a case of SMA embolism secondary to advanced sarcoma of the lower extremities.
Case Presentation:
A 66-year-old man presented with chest and epigastric discomfort that lasted for 1 day. Coronary angioplasty was performed, followed by laparotomy with an embolectomy of the SMA, small bowel resection, and ileostomy. After surgery, leiomyosarcoma was diagnosed on a biopsy performed in the left thigh, and lung metastasis was confirmed. He had recurrent peritonitis for 2 months and died of multiple organ failure.
Clinical Discussion:
The common etiologies of SMA embolism include cardioembolic sources with atrial fibrillation and recent myocardial infarction. Rare etiologies include atherosclerotic plaque, mural thrombus of the aneurysm, and cardiac sarcoma.
Conclusion:
Efforts are required for the systemic evaluation of various etiologies in patients with SMA embolism who require rapid diagnosis and intervention.
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