SUPERIOR MESENTERIC ARTERY THROMBOSIS IN A CASE OF AORTIC DISSECTION

Author Name: 1Dr. Gunjan Mishra, 2 Dr. Sameer Kadam

Volume: 01 &  Issue:

Country: India

DOI NO.: 08.2020-25662434 DOI Link: http://www.doi-ds.org/doilink/01.2021-46883343/UIJIR

Affiliation:

¹PG Resident year III, Department Of General Surgery, MGM Medical College and Hospital, Navi Mumbai

²H.O.D., Department Of General Surgery, MGM Medical College and Hospital, Navi Mumbai

ABSTRACT

Abstract The primary treatment of acute descending thoracic aortic dissection (Stanford type B) remains medical. Surgical intervention for acute type B aortic dissection has been reserved for complications. We present a rare case of type B aortic dissection in a female patient, associated with superior mesenteric artery thrombus. 65/F with pain in abdomen for 4 days, radiating to back, history of one episode of hematemesis, No other symptoms. BP was 200/110 mmHg, abdomen was soft, non-tender, peripheral pulses well felt and peripheries were warm. CXR s/o mediastinal widening. CT angiography s/o type B aortic dissection extending from lower thoracic aorta to the bifurcation of renal arteries, and a partial lumen occluding thrombus in SMA extending to proximal mesenteric arteries, occluding 40-80% of the lumen. Patient was started on antihypertensives, and once the BP was under control, she was started on anticoagulants for the SMA thrombus, and finally discharged on Tab Acitrome 3mg od. Usually involvement of mesenteric arteries is associated with bowel ischaemia/gangrene and may require surgical intervention; however, as evidenced by our case report, observation and conservative management may suffice in cases of mesenteric artery thrombus without any signs of complete luminal obstruction or threatened gangrene of bowel.

Key words: Acute, dissection, artic Dissection, mesenteric artery thrombus.