Rare case of "wandering artery of drummond" as a result of chronic triple mesenteric vessel occlusion treated by isolated angioplasty and stenting of the inferior mesenteric artery.
We report a rare clinical scenario of chronic mesenteric ischemia (CMI) patient with obstruction of all the three major gut vessels including celiac, superior mesenteric artery (SMA), and inferior mesenteric artery (IMA) with a sole artery supplying the collaterals through marginal artery of left colon (the "wandering artery of Drummond"). A 70-year-old man was presented to hospital with acute onset of dyspnea, diaphoresis, severe epigastric pain, nausea, and vomiting that started after lunch. Initially, patient was diagnosed and treated for non-ST elevation myocardial infarction (NSTEMI). Furthermore, work-up, including computed tomographic scan of abdomen followed by angiogram, revealed 100% obstruction of celiac and SMA, whereas inferior IMA had 90% ostial lesion with poststenotic dilatation and collaterals supplying to entire colon. Subsequently, IMA ostial lesion was stented through percutaneous intervention and patient noted significantly improved symptoms and quality of life. To conclude, percutaneous endovascular treatments confer favorable strategy for CMI, and it may either be curative or allow nutritional optimization before definitive surgery.
Department of Medicine, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois.
Tejaskumar
T
Shah
Department of Medicine, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois.
Mukesh
M
Singh
Department of Medicine, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois.
Rohit
R
Bhuriya
Department of Medicine, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois.
Daniela
D
Kovacs
Department of Medicine, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois.
Sandeep
S
Khosla
inferior mesenteric artery; non-ST elevation myocardial infarction; superior mesenteric artery