Intestinal ischaemia

Case contributed by Dr Tim Luijkx

Presentation

Abdominal pain, impaired liver and renal function, increased lactate. Ischaemia?

Patient Data

Age: 80 years
Gender: Female
CT

Filling defect in the distal superior mesenteric artery in keeping with thrombus. Ileal loops distal of this are not enhancing as opposed to proximal jejunal loops.

Normal enhancement of colon. No induration of fat, no free fluid. No intestinal pneumatosis evident.

Sigmoid diverticulosis.

Case Discussion

Findings suggest intestinal ischaemia as a result of thrombus in the superior mesenteric artery.

Unfortunately, there was a delay of about 8 hours until angiographic thrombectomy. At subsequent laparotomy the same day 100 cm of necrotic ileum was resected and at relaparotomy another 80 cm of ileum was resected.

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Case information

rID: 51960
Case created: 15th Mar 2017
Last edited: 4th May 2017
Inclusion in quiz mode: Included

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