A Case of Protein-losing Gastroenteropathy Secondary to Endovascular Treatment of Superior Mesenteric Artery Occlusion

Abstract

An 81-year-old woman who presented to the emergency department complaining of abdominal pain was diagnosed with superior mesenteric artery (SMA) occlusion. Exploratory laparoscopy found no evidence of bowel necrosis. Transcatheter thrombolytic therapy was performed. The subsequent CT scan showed edematous changes in part of the small intestine despite contrast enhancement in the SMA and bowel. The patient had frequent diarrhea and abdominal pain after initial therapy, as well as hypoalbuminemia, considered to be caused by the damaged intestine. This progressed despite the use of human serum albumin. Therefore, re-operation was performed, and 60 cm of intestine were resected, resulting in subsidence of the abdominal symptoms and an increase in the serum albumin level. The resected specimen was dark red, with histopathological changes of mucosal necrosis and an edematous submucosal layer. Protein-losing gastroenteropathy occurring secondary to SMA occlusion has rarely been reported. A case of protein-losing gastroenteropathy treated by intestinal resection is presented.