Abstract
A successful case of superior mesenteric arterial embolectomy with bowel resection is reported.
The patient, an 82-year-old man with atrial fibrillation and cerebral infarction, complained of severe periumbilical pain of acute onset. Physical examination of the abdomen did not reveal tenderness or rebound tenderness. Alightly increased small bowel gas was shown on plain abdominal X-ray film. Ultrasonography and CT of the abdomen revealed no abnormal findings. Since mesenteric arterial occlusion was suspected, intravenous digital subtraction angiography, followed by selective superior mesenteric arteriography, was performed. The artery was completely obstructed at 5cm distal from its origin. About five and a half hours after the onset of the symptoms, the patient underwent an operation. Embolectomy with a Fogarty catheter and small bowel resection of about 65cm were performed. Postoperatively, he was complicated with aspiration pneumonia and renal failure, but he soon recovered.
This patient is the oldest of the successful cases of superior mesenteric arterial embolectomy to be reported in the Japanese literature.
