Superior mesenteric artery and replaced right hepatic artery thrombosis
Presentation
Severe abdominal pain. Bowel obstruction?
Patient Data
There is a total filling defect in the superior mesenteric artery including its branches. The right hepatic artery is thrombosed as it arises from the superior mesenteric artery (anatomical variant), accounting for the right liver lobe hypodensity on the arterial phase due to differential arterial enhancement.
Ischaemic changes of the affected small and large bowel loops.
Incidental findings – hiatus hernia, left adrenal nodule, renal cysts.
Case Discussion
This is a case of a complete superior mesenteric artery thrombosis with ischaemic changes of intestinal system. There is an anatomical variant of right hepatic artery, arising from the superior mesenteric artery and is thrombosed, which accounts for the unusual arterial phase hepatic enhancement. Unfortunately, the patient passed after few hours.
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