A Superior Mesenteric Artery Embolism Associated with Secondary Occurrence of Non-occlusive Mesenteric Ischemia: Treated with Continuous Intravenous and Intra-arterial High-dose Prostaglandin E1

Abstract

A 69-year-old man was seen at the hospital because of sudden onset abdominal pain. Enhanced abdominal CT revealed small bowel ischemia and superior mesenteric artery (SMA) obstruction. Abdominal angiography revealed SMA occlusion and spasm of the branching artery. Because of peritoneal irritation, emergency surgery was performed. We resected the necrotic bowel and performed primary anastomosis. During the operation, continuous intravenous high-dose prostaglandin E1 (PGE1) was started, after that, we treated with intra-arterial high-dose PGE1. Even for SMA obstruction, early administration of continuous intravenous high-dose PGE1 could contribute to improved survival by lowering the risk of the potential intestinal ischemia onset.