Isolated Bypass Surgery for Acute Embolism of the Superior Mesenteric Artery –A Case Report–

Abstract

A 65-year-old man with chronic atrial fibrillation was transferred to our hospital with the complaint of acute abdominal pain. He had ceased taking oral anticoagulant for polypectomy. Enhanced computed tomography revealed that the proximal portion of the superior mesenteric artery (SMA) was occluded and that the distal portion of the SMA was being perfused by collateral flow. Laboratory data revealed no signs of organ ischemia. Under the diagnosis of acute SMA embolism, emergent laparotomy was performed to assess the bowel necrosis and to revascularize the SMA. Because embolectomy with a Fogarty catheter was unsuccessful, bypass surgery to the SMA was performed using a saphenous vein graft. Intestinal resection was not required because there was no bowel necrosis. The patient was discharged 16 days after the operation without clinical signs of recurrent mesenteric ischemia.