Acute superior mesenteric artery embolism: A case report

急性肠系膜上动脉栓塞:病例报告

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Abstract

The incidence rate of superior mesenteric artery embolism (SMAE) is low and its mortality rate is high due to its rapid onset and progression. Due to its clinical manifestations being similar to other acute abdominal diseases, such as gastrointestinal perforation, acute appendicitis and acute pancreatitis, its misdiagnosis rate can reach 75-90%. Reducing the mortality rate of this disease is dependent upon an early diagnosis and timely surgical intervention. In the present case report, the diagnosis and treatment process of a female patient aged 83 years with SMAE were reported. The patient recovered well following timely and effective intervention. The patient was admitted due to acute abdominal pain, and computed tomography angiography (CTA) examination showed filling defect in the superior mesenteric artery (SMA). The patient was diagnosed with SMAE and underwent emergency surgical treatment for a thrombectomy and thrombolysis of the SMA under general anesthesia. After surgery, recanalization of the SMA was achieved. The patient was followed up six months later, and SMA CTA revealed that the main trunk and branches of the SMA were well visualized. In addition, relevant literature was reviewed to improve the understanding and treatment of SMAE among clinicians. If patients experience severe abdominal pain that cannot be relieved by antispasmodic drugs, SMAE should be suspected. Patients with history of atrial fibrillation, valvular heart disease and atherosclerosis need further examination. At present, there is a lack of highly sensitive and specific serological indicators. CTA can provide a diagnosis with high sensitivity and specificity.

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