Hyperhomocysteinemia presenting as superior mesenteric artery thrombosis.
We report a 23-year-old man who presented with acute abdomen. At laparotomy, he was diagnosed to have superior mesenteric artery thrombosis, with consequent extensive intestinal gangrene extending from the proximal jejunum till the mid transverse colon. He subsequently developed dry gangrene of the digits. Further evaluation showed that he had marked hyperhomocysteinemia. The gangrenous bowel was resected, and the homocysteine level normalized with folic acid supplementation. He is well at 1-year follow up. His brother, who was asymptomatic, was also detected to have hyperhomocysteinemia, which responded to folic acid.
Alexander
Thomas
T
Department of Gastroenterology, VSM Hospital, Mavelikara 690 103, Kerala. talex@sancharnet.in
Rajnish
R
R
Balakrishnan
R
R
Shallam
James F
JF
D000328:Adult; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications / Q000175:diagnosis* / Q000235:genetics; D008297:Male; D017538:Mesenteric Artery, Superior; D013927:Thrombosis / Q000209:etiology*