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Case Report

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Acute mesenteric ischemia caused by isolated dissection of the superior mesenteric artery and thrombotic occlusion of its major branches: treatment by systemic thrombolysis with recombinant tissue plasminogen activator (rtPA)

  • ANDREJ BERGAUER1
  • NINA KOBILICA1
  • JOZE MATELA2
  • VOJKO FLIS1

1,Department of Vascular surgery University Hospital Maribor

2,Department of Radiology University Hospital Maribor

DOI: 10.22514/SV52.112010.9 Vol.5,Issue 2,November 2010 pp.40-42

Published: 01 November 2010

*Corresponding Author(s): VOJKO FLIS E-mail: vojko.flis@guest.arnes.si

Abstract

Introduction. Isolated superior mesenteric artery (SMA) dissection, without associated aortic dissection, is relatively uncom-mon. Therefore, there are insufficient data to support a particular therapeutic option in the specific setting of isolated SMA dissection associated with thrombotic complications.

Case report. In this article we describe the diagnosis and treatment of a patient who presented to the Emergency Depar-tment with the clinical picture of an acute abdomen and signs suggestive of acute occlusion of the SMA. Diagnostic studies showed an isolated SMA dissection with acute thrombotic occlusion of its main branches. The patient was successfully treated with systemic recombinant tissue plasminogen activator (rtPA) thrombolysis. To the best of our knowledge, this is the first description of a case of isolated SMA dissection associated with thrombotic occlusion of its main branches. Conclusion. In patients presenting with persistent abdominal pain and unspecific clinical findings, rare causes should be considered because of their life threatening complications. Systemic thrombolysis is a feasible technique for the treatment of isolated SMA dissection associated with thrombotic complications in the absence of bowel necrosis.

Keywords

acute intestinal ischemia, superior mesenteric artery, dissec-tion, thrombosis, systemic lysis, recombinant tissue plasminogen activator (rtPA)

Cite and Share

ANDREJ BERGAUER,NINA KOBILICA,JOZE MATELA,VOJKO FLIS. Acute mesenteric ischemia caused by isolated dissection of the superior mesenteric artery and thrombotic occlusion of its major branches: treatment by systemic thrombolysis with recombinant tissue plasminogen activator (rtPA). Signa Vitae. 2010. 5(2);40-42.

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