Presentation
Abdominal pain.
Patient Data
Intrahepatic portal venous gas. Small ascites. SMV patient. Atherosclerosis at origin of celiac artery. Occlusion/near occlusion of the origin of the SMA. IMA patient with relatively large collaterals heading toward the upper abdomen reconstituting the SMA.
Distal ileal and cecal wall thickening and hypoenhancement. Distal ileal pneumatosis. Associated mesenteric edema with small amount of gas in the draining veins.
Case Discussion
Relatively uncommon presentation of chronic mesenteric ischemia, with narrowing of the celiac axis origin, occlusion of the SMA origin, and reconstitution via collaterals largely supplied by the IMA. The chronic ischemia is largely confined to the ileocolic distribution and includes the distal ileum and cecum, with pneumatosis of the distal small bowel. This patient was treated with several attempts at SMA bypass and eventually underwent resection of the distal small bowel.
Unable to process the form. Check for errors and try again.