Clinics in diagnostic imaging (176). Acute embolic occlusion of the coeliac artery.
- Author:
Chinthaka APPUHAMY
1
;
Justin KWAN
1
;
Martin Weng Chin H'NG
1
;
Sriram NARAYANAN
2
;
Sundeep PUNAMIYA
1
Author Information
- Publication Type:Journal Article
- Keywords: atrial fibrillation; catheter-directed thrombolysis; coeliac artery occlusion; embolus
- From:Singapore medical journal 2017;58(4):184-188
- CountrySingapore
- Language:English
- Abstract: A 52-year-old man, who had a background of chronic heart disease and atrial fibrillation, as well as non-compliance with warfarin therapy, presented with a two-week history of worsening upper abdominal pain. Computed tomography mesenteric angiography showed complete embolic occlusion of the coeliac artery with resultant segmental splenic infarction, and thrombus within the left ventricle. A decision was made to proceed with catheter-directed thrombolysis. Subsequent follow-up angiogram at 12 hours showed successful treatment with complete dissolution of the coeliac embolus. The patient's symptoms resolved during his hospitalisation and he was subsequently discharged well on long-term oral anticoagulation therapy. Isolated acute embolic occlusion of the coeliac axis is a rare occurrence that may result in end-organ infarction. Treatment options include systemic anti-coagulation, mechanical thrombectomy, catheter thrombolysis or open surgery. Catheter-directed thrombolysis therapy is a feasible and effective option for treating acute thromboembolic occlusion of the coeliac artery.
