Vnitr Lek 2008, 54(11):1081-1086

Acute embolization into the veins in the splanchnic bed - an overview of current methods of diagnosis and therapies

R. Miklík^*, P. Kala, J. Maňoušek, M. Poloczek, J. Pařenica, P. Lokaj, J. Špinar

Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC

Acute mesentery artery embolization is a rare diagnosis. In case of late recognition the mortality may reach up to 93%. Acute abdominal pain, vomitus, rapid and sudden bowel evacuation with or without blood are the typical symptoms of the disease. Unfortunately, the symptoms do not often correlate with clinical findings. Plain X-ray of abdomen or CT tomography may show no signs of intestinal ischaemia. The diagnostic method to choose is either spiral CT angiography or contrast angiography, respectively. The most common therapeutical approach is surgical revascularization but in selected cases it is feasible to perform local thrombolysis with a microcatheter placed directly into the occluded artery. Papaverin vasodilatation and intravenous anticoagulation are also justifiable, catheter aspiration and stent implantation have also been challenged. Our review is to provide a detailed up-to-date information about the issue and is an extensive follow-up of our recently published case report [Superior mesentery artery embolization as a complication of the primary angioplasty solved by local thrombolysis. Vnitř Lék 2008; 54(9): 871-875].

Keywords: acute occlusion; superior mesentery artery; embolization; catheterization; thrombolysis; angiography

Received: June 4, 2008; Accepted: July 18, 2008; Published: November 1, 2008  Show citation