Presentation
Abdominal pain, impaired liver and renal function, increased lactate. Ischemia?
Patient Data
Age: 80 years
Gender: Female
From the case:
Intestinal ischemia
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Filling defect in the distal superior mesenteric artery in keeping with embolus. 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 ischemia as a result of embolus 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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