Intra-arterial fibrinolytic treatment for mesenteric arterial embolus: a case report

The diagnosis of mesenteric ischemia is based on acute clinical awareness of the condition and confirmed by angiography or laparotomy. The standard treatment is abdominal exploration with resection of the gangrenous segment of the bowel or embolectomy of the superior mesentery artery, or both. Alternative treatment such as intra-arterial thrombolysis may be considered in selected patients. A 66-year-old man with a history of atrial fibrillation presented with abdominal pain. Angiography documented an embolus in both the ileocolic artery and a branch of the right renal artery. The patient was treated with selective intra-arterial infusion of streptokinase. The abdominal pain resolved. Repeat angiography showed lysis of both emboli.