Bioscience Biotechnology Research Communications

An Open Access International Journal

P-ISSN: 0974-6455 E-ISSN: 2321-4007

Bioscience Biotechnology Research Communications

An Open Access International Journal

Yeshwant. R. Lamture1, Varsha P. Gajbhiye2, Ranjit  Ambad3,
Shivansh Sisodia4 and Jawed Akther5

1Department of General Surgery, Jawaharlal Nehru Medical College Wardha, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India.

2Department of Pharmacology, Datta Meghe Medical College Nagpur. Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India.

3Department of Biochemistry, Datta Meghe Medical College Nagpur. Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India.

4Department of Surgery, Jawaharlal Nehru Medical College Wardha, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India.

5Professor, Department of General Surgery, Jawaharlal Nehru Medical College Wardha, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India.

Corresponding author email: dryrlamture@yahoo.co.in

Article Publishing History

Received: 15/04/2021

Accepted After Revision: 04/06/2021

ABSTRACT:

Superior mesenteric artery occlusion is disease of bad prognosis. Thromboembolism is the common cause of it.  Outcome of this dreaded condition was depended on early detection and proper, surgical, or intravascular intervention to restoration of   blood supply to bowel. Sometime may need resection of bowel and supportive measures. In this report, we report a case of a 52-year gentleman with stenosis of celiac artery which one is critical enough leading to infarction of spleen. He also had also superior mesenteric artery occlusion.  A 52-year-old male presented with c pain in abdomen for 10 days. On Examination of Abdomen and pelvis, patient had tenderness in right lower quadrant of the abdomen with no obvious distension/rigidity/guarding. Ultrasonography of the Abdomen and Pelvis was done which revealed Old Splenic infarct. Investigations revealed Anaemia (7.4 gm%), high WBC count (55,000 cells/mm3), high platelet count (10.12 lakhs/mm3) with Normal Coagulation profile. Hence adequate blood transfusions were given to optimise the haemoglobin levels.

Patient was also given higher antibiotics to control sepsis. Imaging suggestive of sub-acute to chronic thrombosis in mid & distal part of superior mesenteric artery, stenosis of ostium of celiac artery, mild bowel wall oedema of distal ileal loop suggestive of Bowel ischemia and Splenic infarct. Digital Subtraction angiography (DSA) suggestive of tight stenosis of the celiac artery associated with complete thrombotic obstruction of the superior mesenteric artery. he underwent celiac artery stenting with intra-arterial thrombolysis of Superior Mesenteric artery (SMA). Repeat angiography was done post procedure to shows the establishment of flow across the arteries. Patient got relieved from the symptoms gradually. Superior mesenteric artery (SMA) obstruction is known for its high fatality rate. Prompt intervention is a key to success otherwise it leads to drastic complications even death can occur. Interventional radiology is having major role in early phases and surgery work in later stages of this dreadful disease.

KEYWORDS:

Vascular Stenting, Thromboembolism, Bowel Ischaemia.

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