| Synchronous celiac axis and superior mesenteric artery embolism. | |
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MedLine Citation:
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PMID: 22090184 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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We present a case of combined celiac axis and superior mesenteric artery embolism in a 70-year-old patient that was examined in emergency department for atrial fibrillation and diffuse abdominal pain. Standard abdominal x-ray showed air in the portal vein. CT scan with contrast showed air in the lumen of the stomach and small intestine, bowel distension with wall thickening, and a free gallstone in the abdominal cavity. Massive embolism of both celiac axis and superior mesenteric artery was seen after contrast administration. On laparotomy, complete necrosis of the liver, spleen, stomach and small intestine was found. Gallbladder was gangrenous and perforated, and the gallstone had migrated into the abdominal cavity. We found free air that crackled on palpation of the veins of the gastric surface. The patients condition was incurable and she died of multiple organ failure a few hours after surgery. Acute visceral thromboembolism should always be excluded first if a combination of atrial fibrillation and abdominal pain exists. Determining the serum levels of d-dimers and lactate, combined with CT scan with contrast administration can, in most cases, confirm the diagnosis and lead to faster surgical intervention. It is crucial to act early on clinical suspicion and not to wait for the development of hard evidence. |
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Authors:
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Z Rajkovic; Z Zelic; D Papes; K Cizmek; N Arslani |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: VASA. Zeitschrift für Gefässkrankheiten. Journal for vascular diseases Volume: 40 ISSN: 0301-1526 ISO Abbreviation: VASA Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0317051 Medline TA: Vasa Country: Switzerland |
Other Details:
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Languages: eng Pagination: 495-8 Citation Subset: IM |
Affiliation:
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Zabok General Hospital, Zabok, Croatia. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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