Infarcted spleen and stomach with pneumatosis

Case contributed by Dr Chris O'Donnell

Presentation

Hypotension post CABG requiring inotropes and aortic balloon pump. Now sepsis and abdominal distension.

Patient Data

Age: 65
Gender: Male

Marked gas within the wall of the stomach and in the spleen with extraluminal gas bubbles in the left upper quadrant and free gas in the peritoneal cavity. Note air within the aortic balloon (arrow).

Case Discussion

Combination of extreme hypotension, inotropes leading to vasoconstriction and the intra-aortic balloon has caused splenic and left gastric arterial occlusion, infarction of the stomach and spleen and ultimately putrefaction of these organs due to gas-forming organisms. The patient died very soon after this examination.

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Case information

rID: 22209
Case created: 20th Mar 2013
Last edited: 18th Nov 2015
Inclusion in quiz mode: Included

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