Per-catheteric Thrombus Aspiration was Successfully Performed for a Superior Mesenteric Artery Thrombosis Recurrence after the Operation

Tsuyoshi Koyama, Ryoji Kaizaki, Junya Morimoto and Yoshiki Aida*

Department of Surgery and Department of Internal Medicine*, Meijibashi Hospital

Superior mesenteric artery (SMA) thrombosis is difficult to correct without early diagnosis. A 65 year-old man with brain infarction, myocardial infarction, and diabetes mellitus was admitted for epigastralgia. Although blood laboratory tests revealed increased white blood cells and CRP, but no serious pain, so we could not diagnose his SMA thrombosis early. Enhanced CT revealed mesenteric artery occlusion. Surgery was done 44 hours after symptom onset. The small intestine was already infarcted. We resected most of the small intestine, leaving 50 cm of the jejunum, and resected the right colon. Seven days after surgery he suffered right hypochondriac tenderness. Blood laboratory tests revealed increased white blood cells and CRP again. Abdominal angiography showed complete SMA occlusion. Continuous per-catheteric thrombus aspiration successfully got most of the thrombi. To the best of our knowledge, this is only the sixth case of SMA thrombosis treated with per-catheteric thrombus aspiration procedure in Japan.

Key words
superior mesenteric artery thrombosis, per-catheter, thrombus aspiration

Reprint requests
Tsuyoshi Koyama Department of Surgery, Meijibashi Hospital
1-358-3 Miyake-nishi, Matsubara city, 580-0045 JAPAN

Accepted
December 17, 2004

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