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Multimodality Diagnosis of Mesenteric Ischemia

Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

[ACUTE MESENTERIC ISCHEMIA].

Avi Duchno¹, Gil Bachar¹

¹Department of Diagnostic Imaging, Ultrasound and Computed Tomography Units, Hashron Hospital, Petach Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv; Israel.

|June 18, 2025

Summary

A patient with cardiovascular disease and kidney issues experienced a heart attack and underwent surgery. Post-surgery, he developed superior mesenteric artery (SMA) thrombosis, leading to intestinal ischemia requiring further surgical intervention.

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Area of Science:

Cardiovascular Medicine
Gastrointestinal Surgery
Vascular Surgery

Background:

A 61-year-old male with a history of complex cardiovascular disease and chronic kidney disease presented with an anterior ST-elevation myocardial infarction (STEMI).
Catheterization revealed severe multi-vessel coronary artery occlusions, necessitating percutaneous coronary intervention (PCI) and subsequent urgent coronary artery bypass grafting (CABG).

Observation:

The patient developed acute abdominal pain on postoperative day one.
Computed tomography angiography (CTA) confirmed superior mesenteric artery (SMA) thrombosis, indicating acute mesenteric ischemia.

Findings:

The patient required emergent surgical intervention, including bowel resection and thrombectomy, to manage the SMA thrombosis and intestinal ischemia.
This case highlights a rare but serious postoperative complication following cardiac surgery.

Implications:

Early recognition and management of SMA thrombosis are crucial for improving outcomes in patients with complex cardiovascular conditions.
This case underscores the importance of considering vascular complications in the differential diagnosis of postoperative abdominal pain in high-risk patients.
Further research into risk factors and preventative strategies for SMA thrombosis post-cardiac procedures may be warranted.