title: A case of acute superior mesenteric artery embolism with severe ischemic liver injury successfully treated by endovascular treatment.
abstract: We describe an interesting clinical course of a patient who developed severe ischemic liver injury due to acute embolism of the superior mesenteric artery (SMA) and celiac artery. A 70-year-old man was hospitalized for abdominal pain and diarrhea. Abdominal computed tomography demonstrated a variant common hepatic artery arising from the SMA and multiple thromboembolic occlusions of visceral arteries, including the SMA and celiac artery. Laboratory data showed markedly elevated hepatic enzymes, which increased after admission despite the initiation of systemic anticoagulant and thrombolytic therapy. The patient was successfully treated by endovascular recanalization of the SMA occlusion via transcatheter embolus aspiration, thrombolysis, balloon angioplasty, and stent placement. Severe ischemic liver injury may occur in the setting of synchronous embolism of the SMA and celiac artery, and these phenomena may have a critical impact on the choice of treatment strategies and prognosis. Endovascular treatment appears to an effective treatment option.
authors.affiliation: Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.wckyh140@yahoo.co.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Matsui
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Mimura
authors.forename: Takuya
authors.initials: T
authors.lastname: Fukazawa
authors.forename: Ichiro
authors.initials: I
authors.lastname: Morita
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Suehiro
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawamoto
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Naomoto
mesh_terms: D000368:Aged; D000792:Angiography; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000601:surgery; D004617:Embolism / Q000150:complications / Q000601:surgery; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000201:enzymology; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery; D008641:Mesenteric Vascular Occlusion / Q000150:complications* / Q000601:surgery*; D015427:Reperfusion Injury / Q000209:etiology* / Q000601:surgery; D012720:Severity of Illness Index; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome