Presentation
Known hypertension and diabetes, presented with abdominal pain and nausea 3 hours before admission
Patient Data
CT scan shows a completely occluding embolus in the SMA and its branches.
Additional findings:
- The bowel wall lacks contrast enhancement
- Free abdominal fluid (surrounding the liver and the spleen margins)
- Renal simple cyst
- Total occlusion of the right external iliac artery and the left internal iliac artery
Coronal and sagittal CT images show the hypodense embolism within the proximal superior mesenteric artery.
Case Discussion
This case illustrates typical features of superior mesenteric arterial embolism with bowel necrosis, which was confirmed at open surgery.
The patient has some risk factors such as advanced age and atrial fibrillation which are confirmed on ECG. She presented with acute severe abdominal pain and nausea.
CT shows an occluding embolus in the SMA, the bowel wall lacks contrast enhancement, and free abdominal fluid which suggests bowel necrosis.
This patient was taken to surgery, and necrotic bowel was resected and the diagnosis was confirmed.
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