Superior mesenteric artery thrombosis

Case contributed by Dr István Kui

Presentation

Known chronic renal disease, presented with abdominal pain, diarrhea followed by incontinence.

Patient Data

Age: 70 years
Gender: Male
Ultrasound

Ultrasound

  • The lumen of the superior mesenteric artery (SMA) is dilated and contains a thrombus which occludes ~90% of the lumen.
  • Sagittal view of the SMA at 2-3 cm from its origin also shows widening and a partially occlusive thrombus.
  • Absent Doppler flow in the SMA.

CT confirms a partially occlusive thrombus of the SMA.  Distal to the origin we can see a small filling defect, which grooves caudally, occluding 90% of the lumen (arrow).

Additional findings: free abdominal fluid (surrounding the liver and the spleen margins), thinning of both renal parenchyma, thickened and edematous transverse colon, interlobar 3 cm liver cyst. Below the level of the origin of the SMA, filling defect in the right part of the aortic wall

Case Discussion

The patient received anticoagulant therapy only and intestinal ischemia did not develop. The patient’s symptoms resolved and follow up with serial ultrasounds demonstrated a static thrombus without any further progression.

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Case information

rID: 48408
Published: 9th Oct 2016
Last edited: 19th Dec 2019
Inclusion in quiz mode: Excluded

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