Abstract
Superior mesenteric artery (SMA) occlusion causes ischemic changes in the intestine resulting in large-segment necrosis, and the survival prognosis in such cases is dismal. We report a case of SMA occlusion occurring 20 years after a total gastrectomy. Aortic angiography in an 80-year-old woman admitted for sudden onset of severe abdominal pain revealed an embolus completely occluding the SMA trunk. Twelve hours after onset, we conducted an emergency laparotomy. We found that a large segment of the small intestine and part of the transverse colon had undergone ischemic changes. The preserved small intestine was only 30cm from the Treitz ligament. Bowel resection of the large segment and a partial colectomy were done and oral ingestion cleared. The woman died 89 days after surgery of heart failure. SMA occlusion after total gastrectomy is rare, and this is only the third case report.
