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Clinical analysis and literature review of a complicated superior mesenteric artery stenosis with intestinal necrosis: A case report

Superior mesenteric artery (SMA) stenosis, as a common arterial disease, if coexists with other possible causes of abdominal pain, is complicated, which may require not only conservative treatment but also surgical intervention. PATIENT CONCERNS: A 64-year-old male patient who was admitted to our ho...

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Autores principales: Zhou, Binbin, Huang, Junjie, Chen, Xiaobin, Lin, Chen, Xia, Yin, Jiang, Rong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10145880/
https://www.ncbi.nlm.nih.gov/pubmed/37115070
http://dx.doi.org/10.1097/MD.0000000000033586
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author Zhou, Binbin
Huang, Junjie
Chen, Xiaobin
Lin, Chen
Xia, Yin
Jiang, Rong
author_facet Zhou, Binbin
Huang, Junjie
Chen, Xiaobin
Lin, Chen
Xia, Yin
Jiang, Rong
author_sort Zhou, Binbin
collection PubMed
description Superior mesenteric artery (SMA) stenosis, as a common arterial disease, if coexists with other possible causes of abdominal pain, is complicated, which may require not only conservative treatment but also surgical intervention. PATIENT CONCERNS: A 64-year-old male patient who was admitted to our hospital with pain located around the umbilicus and right lower quadrant for 12 hours. DIAGNOSIS: SMA stenosis was initially diagnosed. After balloon dilatation of SMA and stent implantation, computed tomography angiography reexamination showed that the stent was migrated and the stenosis reoccurred. During the ileocecal resection and enterolysis, the necrotic bowel was found and cut open, and the intestinal fistula was found. Combined with his abdominal surgery history, the patient was diagnosed with complicated SMA stenosis with intestinal necrosis. INTERVENTIONS: The balloon dilatation of SMA and stent implantation was performed. Because the stent was migrated and the stenosis reoccurred, so a balloon stent was implanted in the proximal stenosis of SMA again. The patient’s symptoms were relieved and reoccurred again. The ileocecal resection and enterolysis were performed. OUTCOMES: The computed tomography angiography showed that the stents were well deployed and unobstructed after 9 months follow-up. LESSONS: When dealing with undetermined abdominal pain that especially has something to do with mesenteric artery ischemia, if there coexists with other possible causes of abdominal pain, we cannot only focus on vascular diseases. We should be vigilant, integrate multiple factors and their interactions to guarantee the accuracy and timeliness of diagnosis and therapy.
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spelling pubmed-101458802023-04-29 Clinical analysis and literature review of a complicated superior mesenteric artery stenosis with intestinal necrosis: A case report Zhou, Binbin Huang, Junjie Chen, Xiaobin Lin, Chen Xia, Yin Jiang, Rong Medicine (Baltimore) 7100 Superior mesenteric artery (SMA) stenosis, as a common arterial disease, if coexists with other possible causes of abdominal pain, is complicated, which may require not only conservative treatment but also surgical intervention. PATIENT CONCERNS: A 64-year-old male patient who was admitted to our hospital with pain located around the umbilicus and right lower quadrant for 12 hours. DIAGNOSIS: SMA stenosis was initially diagnosed. After balloon dilatation of SMA and stent implantation, computed tomography angiography reexamination showed that the stent was migrated and the stenosis reoccurred. During the ileocecal resection and enterolysis, the necrotic bowel was found and cut open, and the intestinal fistula was found. Combined with his abdominal surgery history, the patient was diagnosed with complicated SMA stenosis with intestinal necrosis. INTERVENTIONS: The balloon dilatation of SMA and stent implantation was performed. Because the stent was migrated and the stenosis reoccurred, so a balloon stent was implanted in the proximal stenosis of SMA again. The patient’s symptoms were relieved and reoccurred again. The ileocecal resection and enterolysis were performed. OUTCOMES: The computed tomography angiography showed that the stents were well deployed and unobstructed after 9 months follow-up. LESSONS: When dealing with undetermined abdominal pain that especially has something to do with mesenteric artery ischemia, if there coexists with other possible causes of abdominal pain, we cannot only focus on vascular diseases. We should be vigilant, integrate multiple factors and their interactions to guarantee the accuracy and timeliness of diagnosis and therapy. Lippincott Williams & Wilkins 2023-04-25 /pmc/articles/PMC10145880/ /pubmed/37115070 http://dx.doi.org/10.1097/MD.0000000000033586 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle 7100
Zhou, Binbin
Huang, Junjie
Chen, Xiaobin
Lin, Chen
Xia, Yin
Jiang, Rong
Clinical analysis and literature review of a complicated superior mesenteric artery stenosis with intestinal necrosis: A case report
title Clinical analysis and literature review of a complicated superior mesenteric artery stenosis with intestinal necrosis: A case report
title_full Clinical analysis and literature review of a complicated superior mesenteric artery stenosis with intestinal necrosis: A case report
title_fullStr Clinical analysis and literature review of a complicated superior mesenteric artery stenosis with intestinal necrosis: A case report
title_full_unstemmed Clinical analysis and literature review of a complicated superior mesenteric artery stenosis with intestinal necrosis: A case report
title_short Clinical analysis and literature review of a complicated superior mesenteric artery stenosis with intestinal necrosis: A case report
title_sort clinical analysis and literature review of a complicated superior mesenteric artery stenosis with intestinal necrosis: a case report
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10145880/
https://www.ncbi.nlm.nih.gov/pubmed/37115070
http://dx.doi.org/10.1097/MD.0000000000033586
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