Infarcted spleen and stomach with pneumatosis
Hypotension post CABG requiring inotropes and aortic balloon pump. Now sepsis and abdominal distension.
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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).
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.