| Abstract [eng] |
Acute intestinal ischaemia - 0.09-0.2% of all acute emergency department conditions, presenting with non-specific symptoms that can be caused by a wide range of conditions. In young patients early diagnosis is often complicated by the absence of comorbidities. There are no specific laboratory tests available so if thromboembolism of the mesenteric arteries is suspected computed tomography angiography should be performed as soon as possible and once the diagnosis is confirmed treatment should be given as soon as possible. We describe a case of a 44-year-old woman with no history of thromboembolic events conservatively treated at Vilnius University Hospital Santaros Klinikos after 3 unsuccessful emboli of the left arm. Due to necrosis, fingers I and II of the left hand were amputated. In the post-operative period the patient complained of increasing abdominal pain, nausea and vomiting. Performed computed tomography angiography showed an embolism of the superior mesenteric artery 8 cm distal to its estuary. Embolectomy of the superior mesenteric artery with autovenous plasty and resection of the small intestine were performed. The patient was investigated for possible sources of embolism. After excluding all possible sources of embolization, paradoxical embolism was suspected due to recurrent thromboembolic events in the arterial system and patent foramen ovale. The aim of this paper is to present a clinical case of acute intestinal ischaemia at a young age and to perform a review of the literature, analysing the diseases that may mimic the symptomatology of thromboembolism of the superior mesenteric artery, and the possibility of paradoxical embolism. |
