A CASE OF ACUTE MESENTERIC ISCHEMIA: DIAGNOSTIC DILEMMA AND SURGICAL CHALLENGE
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i8.44276Keywords:
Bowel obstruction, Mesenteric ischemia, HemoperitoneumAbstract
Mesenteric ischemia is an uncommon condition, and we need to have a high index of suspicion to diagnose and manage this condition. Predisposing conditions such as myocardial infarction, portal hypertension, pancreatitis, inflammatory bowel disease, post-operative states, trauma, and hypercoagulable states such as DVT, pregnancy, and neoplasms should always be accounted for before diagnosing this condition. In emergency situations, surgical exploration is warranted. Here, we present a case of 57-year-old male, known case of DVT RT lower limb, on anticoagulants, presented with the complaints of epigastric pain, absolute constipation, and abdominal distention of 3 days duration. He was investigated and managed by exploratory laparotomy with peritoneal lavage and resection of gangrenous bowel with proximal jejunostomy and distal ileostomy.
Downloads
References
Roussel A, Castier Y, Nuzzo A, Pellenc Q, Sibert A, Panis Y, et al. Revascularization of acute mesenteric ischemia after creation of a dedicated multidisciplinary center. J Vasc Surg 2015;62:1251-6. doi:10.1016/j.jvs.2015.06.204, PMID 26243208
Corcos O, Nuzzo A. Gastro-intestinal vascular emergencies. Best Pract Res Clin Gastroenterol 2013;27:709-25. doi: 10.1016/j. bpg.2013.08.006, PMID 24160929
Bobadilla JL. Mesenteric ischemia. Surg Clin North Am 2013;93:925-40. doi: 10.1016/j.suc.2013.04.002, PMID 23885938
van den Heijkant TC, Aerts BA, Teijink JA, Buurman WA, Luyer MD. Challenges in diagnosing mesenteric ischemia. World J Gastroenterol 2013;19:1338-41. doi: 10.3748/wjg.v19.i9.1338, PMID 23538325
Pecoraro F, Rancic Z, Lachat M, Mayer D, Amann-Vesti B, Pfammatter T, et al. Chronic mesenteric ischemia: Critical review and guidelines for management. Ann Vasc Surg 2013;27:113-22. doi: 10.1016/j.avsg.2012.05.012, PMID 23088809
Obada T, Hamzeh AS, Omar AI, Solly C. An interesting case of acute mesenteric ischemia secondary to nonbacterial thrombotic endocarditis. Am J Gastroenterol 2017;112:S1346.
Wu MY, Lee LC, Chen YL, Chien YC, Ni BY, Hou YT, et al. Ischemic bowel disease due to superior mesenteric artery occlusion: A case report. Reports 2018;1:10. doi: 10.3390/reports1010010
Haghighi L, Hashemi N, Tahermanesh K, Najmi Z, Baba Heydariyan PB, Khaledi M. Mesenteric ischemia in pregnant woman: A case report. J Obstet Gynaecol 2019;39:1012-4. doi: 10.1080/01443615.2019.1572077, PMID 31161835
Boley SJ, Sprayregen S, Veith FJ, Siegelman SS. An aggressive roentgenologic and surgical approach to acute mesenteric ischemia. Surg Annu 1973;5:355-78. PMID 4602220
Published
How to Cite
Issue
Section
Copyright (c) 2022 MOHIT MITTAL, NIMISH GAUR, SANDHYA GHODKE, RAVISHEKAR N HIREMATH, SHARANJIT SINGH BASRA, VISHAL VERMA
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
