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Management of Acute Superior Mesenteric Artery Occlusion by Thrombolytic Therapy

Acute occlusion of the superior mesenteric artery (SMA) causes extensive bowel necrosis, resulting in a poor prognosis with an extremely high mortality rate. An 82-year-old woman was admitted to our hospital with the complaint of abdominal pain. She was diagnosed as having acute SMA occlusion by enh...

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Autores principales: Okamura, Shinichi, Fujiwara, Hitoshi, Sonoyama, Teruhisa, Ochiai, Toshiya, Ikoma, Hisashi, Kubota, Takeshi, Nakanishi, Masayoshi, Kikuchi, Shojiro, Ichikawa, Daisuke, Okamoto, Kazuma, Sakakura, Chohei, Kokuba, Yukihito, Taniguchi, Hiroki, Otsuji, Eigo
Formato: Texto
Lenguaje:English
Publicado: S. Karger AG 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988921/
https://www.ncbi.nlm.nih.gov/pubmed/21103245
http://dx.doi.org/10.1159/000239293
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author Okamura, Shinichi
Fujiwara, Hitoshi
Sonoyama, Teruhisa
Ochiai, Toshiya
Ikoma, Hisashi
Kubota, Takeshi
Nakanishi, Masayoshi
Kikuchi, Shojiro
Ichikawa, Daisuke
Okamoto, Kazuma
Sakakura, Chohei
Kokuba, Yukihito
Taniguchi, Hiroki
Otsuji, Eigo
author_facet Okamura, Shinichi
Fujiwara, Hitoshi
Sonoyama, Teruhisa
Ochiai, Toshiya
Ikoma, Hisashi
Kubota, Takeshi
Nakanishi, Masayoshi
Kikuchi, Shojiro
Ichikawa, Daisuke
Okamoto, Kazuma
Sakakura, Chohei
Kokuba, Yukihito
Taniguchi, Hiroki
Otsuji, Eigo
author_sort Okamura, Shinichi
collection PubMed
description Acute occlusion of the superior mesenteric artery (SMA) causes extensive bowel necrosis, resulting in a poor prognosis with an extremely high mortality rate. An 82-year-old woman was admitted to our hospital with the complaint of abdominal pain. She was diagnosed as having acute SMA occlusion by enhanced CT. Five hours from onset, the first thrombolytic therapy with urokinase was performed, but failed to complete thrombolysis and recanalization of peripheral blood flow. An exploratory laparotomy following the first thrombolytic therapy showed a mild ischemic change in the affected intestine and mesentery, but no sign of necrosis. After the laparotomy, local thrombolytic therapy with angiographic evaluation of blood flow at 24, 36 and 48 h from the first thrombolysis was performed. As a result, the residual thrombus disappeared and all branches of the SMA became well visualized. The patient was discharged well without a second-look operation or major bowel resection. Sequential intermittent thrombolytic therapy with meticulous angiographic evaluation of blood flow is effective for early-stage acute SMA occlusion.
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spelling pubmed-29889212010-11-22 Management of Acute Superior Mesenteric Artery Occlusion by Thrombolytic Therapy Okamura, Shinichi Fujiwara, Hitoshi Sonoyama, Teruhisa Ochiai, Toshiya Ikoma, Hisashi Kubota, Takeshi Nakanishi, Masayoshi Kikuchi, Shojiro Ichikawa, Daisuke Okamoto, Kazuma Sakakura, Chohei Kokuba, Yukihito Taniguchi, Hiroki Otsuji, Eigo Case Rep Gastroenterol Published: September 2009 Acute occlusion of the superior mesenteric artery (SMA) causes extensive bowel necrosis, resulting in a poor prognosis with an extremely high mortality rate. An 82-year-old woman was admitted to our hospital with the complaint of abdominal pain. She was diagnosed as having acute SMA occlusion by enhanced CT. Five hours from onset, the first thrombolytic therapy with urokinase was performed, but failed to complete thrombolysis and recanalization of peripheral blood flow. An exploratory laparotomy following the first thrombolytic therapy showed a mild ischemic change in the affected intestine and mesentery, but no sign of necrosis. After the laparotomy, local thrombolytic therapy with angiographic evaluation of blood flow at 24, 36 and 48 h from the first thrombolysis was performed. As a result, the residual thrombus disappeared and all branches of the SMA became well visualized. The patient was discharged well without a second-look operation or major bowel resection. Sequential intermittent thrombolytic therapy with meticulous angiographic evaluation of blood flow is effective for early-stage acute SMA occlusion. S. Karger AG 2009-09-22 /pmc/articles/PMC2988921/ /pubmed/21103245 http://dx.doi.org/10.1159/000239293 Text en Copyright © 2009 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-No-Derivative-Works License (http://creativecommons.org/licenses/by-nc-nd/3.0/). Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.
spellingShingle Published: September 2009
Okamura, Shinichi
Fujiwara, Hitoshi
Sonoyama, Teruhisa
Ochiai, Toshiya
Ikoma, Hisashi
Kubota, Takeshi
Nakanishi, Masayoshi
Kikuchi, Shojiro
Ichikawa, Daisuke
Okamoto, Kazuma
Sakakura, Chohei
Kokuba, Yukihito
Taniguchi, Hiroki
Otsuji, Eigo
Management of Acute Superior Mesenteric Artery Occlusion by Thrombolytic Therapy
title Management of Acute Superior Mesenteric Artery Occlusion by Thrombolytic Therapy
title_full Management of Acute Superior Mesenteric Artery Occlusion by Thrombolytic Therapy
title_fullStr Management of Acute Superior Mesenteric Artery Occlusion by Thrombolytic Therapy
title_full_unstemmed Management of Acute Superior Mesenteric Artery Occlusion by Thrombolytic Therapy
title_short Management of Acute Superior Mesenteric Artery Occlusion by Thrombolytic Therapy
title_sort management of acute superior mesenteric artery occlusion by thrombolytic therapy
topic Published: September 2009
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988921/
https://www.ncbi.nlm.nih.gov/pubmed/21103245
http://dx.doi.org/10.1159/000239293
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