Presentation
Profuse black diarrhea in known diverticulosis and recurrent diverticulitis.
Patient Data
Calcified SMA plaque with occlusive thrombus. Extensive arterial calcification. Evidence of early ischemic enteritis. Incidental colonic stenosis at the splenic flexure.
Case Discussion
Given the patient's advanced age, frailty, and extensive co-morbidities, she declined surgery. As a result, she was transferred to medical care and anticoagulated, where she recovered remarkably well. Her SMA occlusion was believed to be chronic, and the current presentation represented an acute superimposition. As a result of her chronic SMA low flow state, the bowel benefited from a degree of resistance to acute infarction. She was discharged to the community after a 9-day admission and has, thus far, not represented.
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