A rare case of mesenteric ischemia (intestinal angina) secondary to superior mesenteric artery thrombosis and inferior mesenteric artery atherosclerosis in a patient with liver cirrhosis secondary to schistosomiasis: A case report
- Author:
Monikka Pasawa
1
;
Dizza R. Dujali
1
Author Information
- Publication Type:Case Reports
- Keywords: Chronic Mesenteric Ischemia; Mesenteric Thrombosis; Intestinal Angina; Liver Schistosomiasis
- MeSH: Human; Liver Cirrhosis; Mesenteric Ischemia
- From: Philippine Journal of Internal Medicine 2025;63(4):5-9
- CountryPhilippines
- Language:English
-
Abstract:
Abstract:Chronic mesenteric ischemia is a rare condition accounting for less than 1 in 1,000 hospital admissions secondary to abdominal pain. Usually, at least two of the three visceral vessels need to be affected before a patient develops symptoms. We describe a patient diagnosed with decompensated liver disease secondary to liver schistosomiasis and was admitted and managed as chronic mesenteric ischemia secondary to superior mesenteric artery (SMA) thrombosis and inferior mesenteric artery (IMA) atherosclerosis. With the patient’s consent, this case is presented to contribute to current knowledge about mesenteric ischemia.
Case Description:A 47-year-old male diagnosed with liver cirrhosis secondary to liver schistosomiasis came in due to 1- month abdominal pain associated with 2 days’ melena, diarrhea, vomiting, and 1-day disorientation. Three days post admission, he was noted with resolution of melena, diarrhea, vomiting, and disorientation; however, persistence of abdominal pain prompted consideration of chronic mesenteric ischemia and was confirmed via plain computed tomography scan. Exploratory laparotomy revealed diffuse discoloration of the small bowel but with peristalsis, thrombosis at SMA, and atherosclerosis at IMA. Heparin drip was given as management for portal vein thrombosis. He recuperated well and eventually was discharged improved.
Conclusion:Chronic mesenteric ischemia is a rare clinical symptom that occurs in less than 1 of 1,000 hospitalizations that are caused by abdominal pain. It has vague abdominal symptoms and is associated with a high mortality rate of 60% to 100%. Prognosis depends on early detection and intervention, and surgical treatment remains the option of choice. - Full text:20260630143056092472-2024-336.pdf
