Small intestine subtotal resection due to mesenteric thrombosis (case report)

Abstract

  The paper presents heavy clinical case of mesenteric vascular thrombosis with subtotal segmental necrosis of the small intestine. The patient was transferred from cardiac surgery clinic in critical condition, where he underwent coronary artery bypass and a prosthetic valve replacement with a biological valve.  The postoperative period was complicated by bleeding from the wound and gastroduodenal bleeding. Rethoracotomy and hemostasis has been performed. After rethoracotomy the patient developed acute abdomen due to mesenteric vascular thrombosis. Initially the acute abdominal clinic was not obvious. The diagnosis was made by abdominal computed tomography using oral and intravenous contrast. An emergency laparotomy was performed, segmental thrombosis of the small intestine was confirmed. More than two meters of small bowel resection was performed. 10 cm of terminal ileum was left on Treitz side. A Maidley type operation was performed. In spite of the patient’s very heavy general condition, after adequate treatment, his condition improved and was discharged from the clinic under the supervision of a surgeon.