Acute Mesenteric Infarction Associated with Atrial Fibrillation  

Oleh:

Wang, Jia-Ming ; Chang, Shih-Chieh

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 364 no. 14 (Apr. 2011), page 1349.
Topik: Chronic Atrial Fibrillation
Fulltext: Mesenteric Infarction.jpeg (261.43KB)

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2011.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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A 75-year-old woman with chronic atrial fibrillation presented to the hospital with a 2-day history of colicky abdominal pain. The physical examination revealed hypoactive bowel sounds and diffuse abdominal tenderness. Laboratory tests showed a white-cell count of 19,400 per cubic millimeter with 92% neutrophils, a blood urea nitrogen level of 42 mg per deciliter (15 mmol per liter), and a serum creatinine level of 3.0 mg per deciliter (267 µmol per liter). Abdominal computed tomography with contrast material showed occlusion of the main trunk of the superior mesenteric artery with mesenteric venous gas (Panel A, reconstructed coronal image, arrow) and pneumatosis intestinalis (arrowhead). Laparotomy revealed ischemic changes with congestion and transluminal necrosis of the small bowel (Panel B) and ascending colon. The superior mesenteric artery is susceptible to embolic occlusion because of its large caliber and narrow take-off angle from the aorta. Although surgical resection of the necrotic bowel is the treatment of choice, the patient and her family opted for conservative treatment. The patient died 3 days later.

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