Abstract
Superior mesenteric artery occlusion （SMAO） is associated with a poor prognosis as it rapidly progresses to intestinal ischemia and necrosis. The clinical manifestations of SMAO have no specific symptoms during the early phase of the disease and diagnosis is difficult. We describe a case of SMAO in a patient with cancer of the oral floor.
A 73-year-old woman who had been treated with warfarin for atrial fibrillation presented with a chief complaint of intractable ulcer of the oral floor, which we diagnosed as squamous cell carcinoma. Antithrombotic therapy was provided with a heparin bridge for the perioperative period, and the patient underwent resection of the cancer of the oral floor. Two days later, the patient complained of a stomachache. Computed tomography findings revealed SMAO three hours after the stomachache worsened. The patient was treated by interventional radiology （IVR）, thrombus aspiration and urokinase. These measures consequently reduced the stomachache within three hours and restored blood flow.
Elderly persons with heart disorders who develop acute abdominal pain are at high risk of SMAO, and it is important to recognize this. The present findings indicated that contrast-enhanced CT, IVR and D-dimer monitoring can be useful for an early diagnosis of SMAO.
