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At the present level of development of medicine, a group of disorders of mesenteric blood flow remains extremely difficult to diagnose. High mortality at this disease is related to the late detectability, lesion volume, patient's age and the presence of severe comorbidity. However, modern specialized hospitals, with a large arsenal of diagnostic methods, as well as a high level of surgical care in this group of patients apply endovascular interventions for early detection of disease and its possible correction.

Case report describes a clinical case of the female patient A., 58 years old, who was treated at the neurovascular department of Belgorod regional clinical hospital named after St. Ioasaf, with acute stroke of ischemic type in the left hemisphere of the brain, cardioembolic subtype. On the 5th day of hospital treatment, the patient complained on a discomfort and further abdominal pain, bloating - suspected mesenteric ischemia. The patient underwent spiral computed tomography (CT) with bolus-enhansment: diagnosed significant stenosis of celiac trunk (CT), subtotal stenosis of the proximal segment of the superior mesenteric artery (SMA) with signs of local occlusion. As a matter of urgency, in endovascular operating room, patient underwent endovascular procedure: Angiography of visceral branches of the abdominal aorta, followed by thrombectomy and stenting. Control angiography - hemodynamics in the stented segment - is not disturbed, the width of the arterial lumen is fully restored, signs of dissection and distal embolism are absent.

Conclusions: angiographic diagnostic methods in patients with mesenteric arteries thromboembolism is a highly informative, they do not require special preparation of the patient and it can immediately perform a medical intervention. Endovascular diagnosis and treatment can be recommended as a method of choice in the diagnosis and treatment of such severe disease as acute mesenteric thrombosis and thromboembolism. 



1.     Atayan A.A. Optimizacia lechebno-diagnosticheskoy taktiki u bolnih s ostroy intestinalnoy ishemiei. [Optimization of treatment and diagnostic tactics in patients with acute intestinal ischemia]. Diss. kand. med. Moskva. 2013:124 s [In Russ].

2.     Ermolov A.S., Alekseechkina O.A., Abuchina V.M. i dr. Vozmozhnosti ultrazvukovogo issledovaniya v diagnostike neokkluzionnogo narusheniya krovoobrashenia kishechnika. [Possibilities of ultrasound in the diagnosis of nonocclusive mesenteric blood-flow disorders]. Diagnosticeskaya I intervancionnaya radiologia. 2015; 9(2): 10-15 [In Russ].

3.     Goleanu V, Alecu L, Lazar O. Acute mesenteric ischemia after heart surgery. Chirurgia (Bucur). 2014; 109(3):402-6.

4.     Pokrovskiy A.V., Yudin V.I. Ostraya mezenterial’naya neprokhodimost. Klinicheskaya Angiologia: rukovodstvo pod red. A.V.Pokrovskogo. [Acute mesenteric ischemia. Clinical angiology: under edition of A.V.Pokrovskiy]. V dvuh tomah. Tom 2. M: Meditsina. 2004; 626-645 [In Russ].

5.     Trotter LBG. Tiedemann: embolism and thrombosis of mesenteric vessels. Cambridge. Cambridge University Press. 1913: 143.

6.     Yushkevich D.V., Hryischanovich V.Ya., Ladutko I.M. Diagnostika i lechenie ostrogo narusheniya mezenterialnogo krovoobrasheniya: sovremennoe sostoyanie problemi. [Diagnostics and treatment of acute disorders of mesenterial blood flow: modern condition of problem]. Medicinskiy nauchniy zhurnal: nauchno-practicheskiy retsenziruemiy zhurnal. 2013; 3: 38-44 [In Russ].

7.     Andrew Oldenburg W., Louis Lau L., Thomas J. Rodenberg, Hope J. Edmonds, Charles D. Burger Acute Mesenteric Ischemia: A Clinical Review. Arch Intern Med. 2004;164(10):1054-1062.

8.     Eliot J.W. The operative relief of gangrene of the intestine due to occlusion of the mesenteric vessels. Ann. Surg. 1895;21:9-23.

9.     Davidov Yu.A. Infarkt kishechnika i hronicheskaya mesenterial’naya ishemiya. [Intestinal infarction and chronic mesenteric ischemia]. M: Medicina. 1997; 208 [In Russ].

10.   Savelev V.S., Spiridonov I.V. Ostrie narusheniaya mesenterialnogo krovoobrashenia. [Acute mesenteric blood-flow disorders]. M: Medicina. 1979; 232 [In Russ].

11.   Savelev V.S., Spiridonov I.V., Boldin B.V. Ostrie narusheniaya mesenterialnogo krovoobrashenia. Infarkt kishechnika. Rukovodstvo po neotlozhnoy hirurgii pod red. V.S. Savel’ev [Acute mesenteric blood-flow disorders. Intestinal infarction. Urgent surgery guideline under edition of V.S. Savel’ev]. Triada-X. 2005; 281-302 [In Russ].

12.   Shugaev A.I., Vovk A.V., Babkin V.Ya. Ostrie narusheniya mezenterialnogo krovoobrasheniya - aktualnaya problema v neotlozhnoi khirurgii organov brushnoi polosti. [Acute disorders of mesenteric blood flow - an actual problem of urgent abdominal surgery]. Ambulatornaya hirurgia. Statsionarzameshayushie tehnologii. 2005;20 (4):112 [In Russ].

13.   Grinberg A.A. Neotlozhnaya abdominalnaya hirurgia. [Urgent abdominal surgery (guide-book for phisicians)]. M: Triada-X. 2000: 496 S. [In Russ].

14.   Acosta S. Epidemiology of mesenteric vascular disease: clinical implications. Semin Vasc Surg. 2010 Mar; 23(1):4-8.

15.   Bradbury A.W., Brittenden, J.McBride, K.Ruckley, C.V. Mesenteric ischaemia: a multidisciplinary approach. Br. J. Surg. 1995;821446-1459.

16.   Solomentseva T.A.. Ostrie narusheniya mesenterialnogo kroovbrasheniya v terapevticheskoi clinike. [Acute disorders of mesenteric blood flow in therapeutic clinics.] Ostrie I neotlozhnie sostoyania v praktike vrachha. (Electronic version - 2011: #2(26) [In Russ].

17.   Acosta S., Ogren M., Sternby N.H. et al. Mesenteric venous thrombosis with transmural intestinal infarction: a population-based study. J. Vasc. Surg. 2005; 41: 1683-1688.

18.   Timerbulatov Sh.V., Sagitov R.B., Sultanbaev A.Y., Asmanov D.I. Diagnostika ishemicheskih povrazhdeniy pri ostrih hirurgicheskih zabolevaniyah organov brushnoi polosti. [Diagnostics of ischemic lesions in patients with acute diseases of abdominal organs]. Klinicheskaya o eksperimentalsya hirurgia. 2012; 3: 40-52 [In Russ].

19.   Lubyanskiy V.G., Zharikov A.N., Kanteeva Ju.L.. Hirurgicheskoe lechenie bolnih s ostrim mesenterial’nim trombozom s nekrozom kishki I peritonitom. [Surgical treatment of patients with acute mesenteric thrombosis complicated by intestinal necrosis and peritonitis]. Kubanskiy nauchniy meditsinskiy vestnik. 2013; 138 (3): 85-89 [In Russ].

20.   AbuRahma A.F., Stone P.A., Bates M.C., Welch C.A. Angioplasty/stenting of the superior mesenteric artery and celiac trunk: Early and late outcomes. J Endovasc Ther. 2003;10:1046-1053.

21.   Hadi Rokni Yazdi, Fadi Youness, Sandeep Laroia, Shiliand Sun, Hicham Abada, Melhem Sharafuddin, Jafar Golzarian. Mesenteric Artery Stenting for Chronic Mesenteric Ischemia. Vascular disease management. 2007;4(6): 180-184.

22.   Hoffmann M., Keck T. Management of mesenteric ischemia and mesenteric vein thrombosis. Dtsch Med Wochenschr. 2014 Jul;139(30):1540-4.

23.   Cunningham C.G. et al. Chronic visceral ischemia. Ann Surg. 1991 Sep;214(3):276-87.

24.   Kubanov A.V., Rudman V.Ya., Grigoriev I.A., Shubin E.A., Polyarush V.P., Letskin A.Ya., Poshataev K.E. Sluchai uspeshnogo endovaskularnogo lesheniya ostrogo tromboza verkhney brizheechnoi arterii. [Case report: successful endovascular treatment of acute thrombosis of superior mesenteric artery]. Dalnevostochniy medicinskiy zhurnal. 2013; 2: 95-97 [In Russ].

25.   Arthurs Z.M., Titus J., Bannazadeh M. A comparison of endovascular revascularization with traditional therapy for the treatment of acute mesenteric ischemia, J. Vascular Surgery. 2011 № 53(3): 698-704.

26.   Urayama H, Ohtake H, Kawakami T, Tsunezuka Y Yokoi K, Watanabe Y Acute mesenteric vascular occlusion: analysis of 39 patients. Eur J Surg. 1998 Mar; 164(3): 195-200. (АНГИОЛОГИЯ.ру) - портал о диагностике и лечении заболеваний сосудистой системы