title: Embolic superior mesenteric artery (SMA) occlusion secondary to a cardiac sarcoma.
abstract: We present a case of embolic acute mesenteric ischaemia (AMI) secondary to an underlying cardiac sarcoma, an exceedingly rare presentation only reported twice before. A 46-year-old man presented to accident and emergency department during the night with severe abdominal pain and vomiting. An urgent CT angiograph demonstrated superior mesenteric artery (SMA) occlusion with ischaemic small bowel. Joint surgical effort from vascular and general surgeons successfully recanalised the SMA and a 20 cm segment of small bowel was resected. Postoperatively, an echocardiogram demonstrated a mass within the left atrium. After cardiothoracic resection, the mass was found to be a rare undifferentiated cardiac sarcoma. Further staining on the embolus retrieved from the SMA revealed scattered spindle cells with a similar immunohistochemistry profile to that of the resected cardiac sarcoma. The patient was subsequently discharged well on lifelong warfarin.
authors.affiliation: Department of General Surgery, Ashford and Saint Peter's Hospitals NHS Trust, Surrey, UK.
authors.forename: Alexander
authors.initials: A
authors.lastname: Robinson
authors.affiliation: Department of Accident and Emergency, Ashford and Saint Peter's Hospitals NHS Trust, Surrey, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Woodman
authors.affiliation: Department of General Surgery, Ashford and Saint Peter's Hospitals NHS Trust, Surrey, UK.
authors.forename: Baris
authors.initials: B
authors.lastname: Ozdemir
authors.affiliation: Department of General Surgery, Ashford and Saint Peter's Hospitals NHS Trust, Surrey, UK.
authors.forename: Ary
authors.initials: A
authors.lastname: Phaily
mesh_terms: D000072226:Computed Tomography Angiography; D004452:Echocardiography; D006338:Heart Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000473:pathology*; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D012509:Sarcoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D014859:Warfarin