Pulmonary embolism with superior mesenteric artery thrombosis

Case contributed by Ayaz Hidayatov
Diagnosis certain

Presentation

A middle-aged woman presents with dyspnea and severe abdominal pain.

Patient Data

Age: 50
Gender: Female

CTA demonstrates multiple filling defects at the bifurcation of the pulmonary trunk (saddle pulmonary embolism) extending to the segmental branches of both pulmonary arteries.

There is also a large filling defect in the superior mesenteric artery (SMA) compatible with thrombus which extends into the abdominal aorta.

The right heart chambers are dilated.

There are patchy and well demarcated hypodense areas due to hypoperfusion of the both renal parenchyma representing infarction.

Case Discussion

The case illustrates that thromboembolism can lodge in pulmonary arteries and in visceral circulation at the same time. 

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