Revascularization of Isolated Superior Mesenteric Artery Dissection for Post-Mesenteric Infarction Exudative Enteropathy: The Contribution of a Multidisciplinary Care Teamwork.
Ann Vasc Surg
; 73: 508.e7-508.e10, 2021 May.
Article
em En
| MEDLINE
| ID: mdl-33338574
ABSTRACT
BACKGROUND:
Isolated dissection of the superior mesenteric artery (SMA) is increasingly diagnosed; the conservative treatment appears to be the best option when blood supply is maintained. However, some patients require a more invasive attitude, due to acute or chronic ischemic complication. Multidisciplinary care within a health-care network improves medical and surgical support. We present a case of chronic complication of isolated SMA dissection requiring a revascularization, followed by bowel resection. CASE PRESENTATION A 49-year-old man presented abdominal pain secondary to necrotizing enterocolitis of unknown cause. An isolated small bowel resection with immediate restoration of continuity was first performed to remove the necrotic tissue. The patient developed post-ischemic exudative enteropathy and small intestinal bacterial overgrowth (SIBO). Re-examination of the first computed tomography (CT) scan revealed an isolated dissection of the SMA that had not been diagnosed. The patient was then successfully treated by superior mesenteric revascularization, and after recovering, he underwent small bowel resection for chronic ischemia.CONCLUSIONS:
SMA revascularization has to be performed in case of SMA dissection complicated of bowel ischemia. Enteropathy is a rare complication of chronic mesenteric ischemia requiring digestive and vascular management in a dedicated health-care team.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Equipe de Assistência ao Paciente
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Enteropatias Perdedoras de Proteínas
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Procedimentos Cirúrgicos do Sistema Digestório
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Procedimentos Cirúrgicos Vasculares
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Artéria Mesentérica Superior
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Isquemia Mesentérica
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Dissecção Aórtica
Tipo de estudo:
Etiology_studies
Limite:
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Ann Vasc Surg
Assunto da revista:
ANGIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
França