1/31. Idiopathic mesenteric thrombosis following caesarean section.Mesenteric venous thrombosis, "the great mimicker", is a very rare disorder in pregnancy and the puerperium, particularly when not associated with any pre-existing thrombophilia or autoimmune states. We describe a patient requiring a resection of 150 cm of gangrenous small bowel after uncomplicated elective Caesarean section. The only risk factor for thrombosis was recovery from an elective Caesarean section, a condition classified by the Royal College of Obstetricians and Gynaecologists as "low risk". death from thromboembolism is the leading cause of maternal mortality and should always be considered with unusual post partum symptoms. early diagnosis of mesenteric vascular occlusion is difficult and recent evidence suggests that elevated GST isoenzyme may be helpful. In all cases of MVT anti-coagulation is the basis of treatment. patients who are not anti-coagulated after surgery have a recurrence rate of 25 per cent compared with 13 per cent of heparinised post-operative patients. As no other pre-existing cause for MVT was found, management was with warfarin for 6 months, the oral contraceptive pill was contraindicated and heparin prophylaxis was recommended for future pregnancies.- - - - - - - - - - ranking = 1keywords = thromboembolism, embolism (Clic here for more details about this article) |
2/31. Superior mesenteric and renal artery embolism during PTA and re-stenting of infrarenal abdominal aorta. Report of a case and review of the literature.The authors report a case of acute superior mesenteric and right renal artery embolism that occurred during an interventional radiological procedure on the abdominal aorta of a young diabetic woman. The onset of a severe abdominal pain during the procedure evoked the clinical suspicion of intestinal ischemia related to the dislodgement of atheroembolic material into the mesenteric artery; the event was correctly diagnosed, but the surgical therapy was delayed by many hours because of the fact that the patient was in a peripheral hospital of the region and had to be transferred to our institution. Fortunately in spite of the considerable delay, the operation was fully successful, probably because of the favourable location of the embolus, which allowed collateral splanchnic circulation to maintain a good metabolic balance.- - - - - - - - - - ranking = 0.13067141684732keywords = embolism (Clic here for more details about this article) |
3/31. Acute abdomen during adjuvant chemotherapy: superior mesenteric artery thrombosis associated with CMF chemotherapy.We report a case of superior mesenteric artery thrombosis in a 57-year-old woman undergoing chemotherapy for T1N1M0, breast cancer. Although cancer itself is associated with an increased risk of thrombotic events, treatment with chemotherapy and/or tamoxifen in breast cancer patients increases this risk. Most cases reported are of venous thromboembolism; arterial events are rare.- - - - - - - - - - ranking = 1keywords = thromboembolism, embolism (Clic here for more details about this article) |
4/31. Treatment of superior mesenteric artery embolism with a fibrinolytic agent: case report and literature review.Successful treatment of superior mesenteric artery embolism depends on an aggressive approach in patients at risk for mesenteric ischemia. This approach favors an early diagnosis and permits the reestablishment of arterial flow within an appropriate time, with prevention of vasospasm and control of organic insufficiencies. We report here a case of superior mesenteric artery embolism in which arterial flow was reestablished by selective intra-arterial infusion of streptokinase. The literature has reported 18 similar cases thus far. This procedure could be an alternative to embolectomy in selected patients, i.e., patients with an early diagnosis, no evidence of intestinal necrosis and with partial occlusion and/or occlusion of secondary branches of the superior mesenteric artery. Frequent arteriographies and intensive care are necessary in this approach. The patient should be continuously monitored because of the possibility of treatment failure and the need for embolectomy.- - - - - - - - - - ranking = 0.15680570021678keywords = embolism (Clic here for more details about this article) |
5/31. Superior mesenteric arterial embolism: treatment by trans-catheter thrombo-aspiration.A 57-year-old woman with hypertension, mixed mitral valve disease, and atrial fibrillation was admitted to our hospital because of abdominal pain continuing for several hours. On the following day, colonoscopy was performed, and diffuse yellow-white pseudomembranous changes were seen in the right hemicolon, but there were no abnormal findings in the left hemicolon; 24 h after onset, a diagnosis of superior mesenteric arterial embolism was made on the computed tomography (CT) scan findings. Abdominal angiography was performed and showed complete occlusion of the superior mesenteric artery (SMA). Then conservative treatment, using per-catheteric thrombus aspiration, was done, followed by intraarterial injection of tissue type plasminogen activator. After the thrombo-aspiration, the filling deficit of the main artery had disappeared, and the branches on the right side were clearly delineated. After the treatment, the symptoms such as abdominal pain and diarrhea improved accordingly. She was discharged from the hospital 27 days later. Our case suggests that trans-catheter thrombo-aspiration is a possible alternative to open embolectomy for some cases of SMA embolism more than 10 h post-onset.- - - - - - - - - - ranking = 0.15680570021678keywords = embolism (Clic here for more details about this article) |
6/31. Successful local fibrinolytic treatment and balloon angioplasty in superior mesenteric arterial embolism: a case report and literature review.We present the case of a 72-year-old man with atrial fibrillation who developed an embolic occlusion of the superior mesenteric artery. He was successfully treated with local fibrinolysis using streptokinase associated with angioplasty. Such local treatments without the need of surgery are very rarely reported in the literature because of the great difficulty in selecting patients without intestinal necrosis, but represent an important option in the algorithm for the management of acute mesenteric ischemia. The patient was in good condition without recurrent embolism during the six months follow-up.- - - - - - - - - - ranking = 0.13067141684732keywords = embolism (Clic here for more details about this article) |
7/31. Superior mesenteric vein thrombosis following laparoscopic Nissen fundoplication.This report describes the second case of a superior mesenteric and portal vein thrombosis following an uneventful laparoscopic Nissen fundoplication. The patient presented on postoperative day 10 with acute onset of abdominal pain and inability to tolerate oral food. A computed tomography (CT) scan revealed superior mesenteric and portal venous thrombosis with questionable viability of the proximal small bowel. He was heparinized and taken for emergent exploratory laparotomy. At surgery and at a planned re-exploration the following day, the bowel was viable and no resection was needed. Despite continuation on anticoagulation therapy, he developed a pulmonary embolism. A hypercoagulable workup was normal. After continued anticoagulation therapy and supportive care, a duplex ultrasound 2 months after the event showed normal flow in both the superior mesenteric and portal veins. Possible mechanisms are discussed along with a review of the pertinent literature.- - - - - - - - - - ranking = 0.026134283369464keywords = embolism (Clic here for more details about this article) |
8/31. Acute superior mesenteric artery embolism: rapid reperfusion with hydrodynamic thrombectomy and pharmacological thrombolysis.PURPOSE: To report a case of acute superior mesenteric artery (SMA) embolism successfully treated with hydrodynamic thrombectomy and pharmacological thrombolysis. CASE REPORT: A 67-year-old man was admitted to the hospital with acute severe abdominal pain. Selective angiography via a femoral puncture revealed a complete embolic occlusion distal to the first jejunal branch of the SMA. Hydrodynamic thrombectomy resolved the severe abdominal pain of the patient in approximately 10 minutes after the start of thrombectomy. Local continuous thrombolysis with urokinase resulted in near complete restoration of the mesenteric flow after 24 hours. The patient made an uneventful recovery and continues to do well on warfarin therapy 8 months after treatment; he has shown no evidence of malabsorption. CONCLUSIONS: Although insertion of the device into the SMA via a femoral puncture is a difficult approach, we propose that hydrodynamic thrombectomy followed by local thrombolysis is a useful treatment for acute superior mesenteric artery embolism.- - - - - - - - - - ranking = 0.15680570021678keywords = embolism (Clic here for more details about this article) |
9/31. Emergency CT scan for the diagnosis of superior mesenteric artery embolism. Report of 2 cases.Two patients with superior mesenteric artery embolism are presented. In both cases, contrast-enhanced computed tomography (CT) demonstrated enhancement of the superior mesenteric artery roots and non-enhanced filling defect in the more distal part of the artery. Immediate extraction of the embolus saved 1 patient but massive bowel resection was necessary in another. Mesenteric arteriography has been the golden standard for the diagnosis of mesenteric occlusion, but it is usually time-consuming and not universally available. On the other hand, CT equipment is in widespread use and the examination can be performed much more easily. patients with unexplained acute abdominal pain should undergo CT examination and be screened for mesenteric arterial occlusion.- - - - - - - - - - ranking = 0.13067141684732keywords = embolism (Clic here for more details about this article) |
10/31. Superior mesenteric artery embolism: treatment with intraarterial urokinase.Four patients with a superior mesenteric artery (SMA) embolism were successfully treated with intraarterial urokinase. angiography showed partial SMA occlusion by intraluminal thrombus in two cases and almost total occlusion in two cases. laparotomy was performed in the latter two cases, one of which required resection of infarcted bowel. Several additional reports of partially occluding SMA emboli treated successfully with streptokinase were found in the literature. The use of intraarterial thrombolytic drugs is an important addition to the treatment of mesenteric embolism that, in some cases, can eliminate or simplify surgical management.- - - - - - - - - - ranking = 0.15680570021678keywords = embolism (Clic here for more details about this article) |
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