A case report of successful catheter guided thrombolysis of acute mesenteric embolism in a patient of paroxysmal atrial fibrillation.

Dr Rajeev Bagarhatta; Dr Mayank Sarawag

Volume : VIII, Issue : VI, June - 2019

A case report of successful catheter guided thrombolysis of acute mesenteric embolism in a patient of paroxysmal atrial fibrillation.

Dr Rajeev Bagarhatta, Dr Mayank Sarawag

Abstract :

A sixty year old elderly female residing at Sawai Madhopur, Rajasthan comes with one day history of diffuse non localising abdominal pain. She had history of paroxysmal AF for which she was cardioverted recently and she was maintaining sinus rhythm on admission. Other than chronic hypertension she did not have any other significant co morbidities. On admission to Gastroenterology Department in SMS Hospital on 19th Nov. 2017 she was evaluated and CT Angiography of abdomen suggested a subtotal occlusion of distal superior mesenteric artery with thrombo–embolus. She was referred to cardiology department for evaluation. On examination and appropriate work up she consented to give percutaneous catheter based thrombolysis for 24 hours by urokinase infusion through femoral artery access. During therapy she developed fever and raised leukocyte counts but otherwise had no remarkable events. Repeat CT Angiography of abdomen showed cleå of thrombo–embolus. This is one rare kind of case report where subtotal occlusion of superior mesenteric artery (SMA) from presumably cardio–embolism due to paroxysmal AF was successfully treated with catheter guided thrombolysis. She was discharged after uneventful recovery on 30th Nov. 2017. On follow up she seems to be fine and had no further pain abdomen.