Treatment of superior mesenteric artery embolism with a fibrinolytic agent: case report and literature review.
Successful treatment of superior mesenteric artery embolism depends on an aggressive approach in patients at risk for mesenteric ischemia. This approach favors an early diagnosis and permits the reestablishment of arterial flow within an appropriate time, with prevention of vasospasm and control of organic insufficiencies. We report here a case of superior mesenteric artery embolism in which arterial flow was reestablished by selective intra-arterial infusion of streptokinase. The literature has reported 18 similar cases thus far. This procedure could be an alternative to embolectomy in selected patients, i.e., patients with an early diagnosis, no evidence of intestinal necrosis and with partial occlusion and/or occlusion of secondary branches of the superior mesenteric artery. Frequent arteriographies and intensive care are necessary in this approach. The patient should be continuously monitored because of the possibility of treatment failure and the need for embolectomy.
Savassi-Rocha
Paulo Roberto
PR
Service of Gastroenterology, Nutrition and Surgery of the Digestive Apparatus (GEN-CAD), University Hospital, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Veloso
Luiz Fernando
LF
D004359:Drug Therapy, Combination; D004617:Embolism / Q000188:drug therapy*; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008638:Mesenteric Arteries; D008641:Mesenteric Vascular Occlusion / Q000188:drug therapy*; D008875:Middle Aged; D010208:Papaverine / Q000627:therapeutic use; D013300:Streptokinase / Q000008:administration & dosage / Q000627:therapeutic use*; D015912:Thrombolytic Therapy; D014665:Vasodilator Agents / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D014665:Vasodilator Agents; D010208:Papaverine; D013300:Streptokinase