Abstract
A 83-year-old woman visited our hospital with a 2-day history of abdominal pain. He had mild tenderness all over the abdomen, but no signs of peritoneal irritation. Abdominal contrast-enhanced CT revealed thrombus in the main trunk of the superior mesenteric artery (SMA), however there were no signs of intestinal necrosis. Since there were no symptoms of intestinal necrosis, conservative treatment was instituted. CT done 12 hours after the initial CT showed no symptoms of intestinal necrosis. But the abdominal pain was not reduced, thrombolysis via a catheter placed in the superior mesenteric artery (SMA) was planned. Urokinase was administered by continuous infusion at the dose of 240000 units/day for 3 days. Angiography confirmed significantly decreased thrombus in the main trunk of the SMA. In addition, the clinical symptom was also disappeared. The subsequent clinical course was satisfactory. Thrombolysis via a catheter placed in the SMA could be an effective treatment option for sub-acute SMA thrombosis without intestinal necrosis.
