CLINICAL CASE OF SUCCESSFUL X-RAY ENDOVASCULAR TREATMENT OF THE SUPERIOR MESENTERIC ARTERY LARGE JEJUNAL BRANCH SUBOCCLUSION IN PATIENT WITH MURAL THROMBOSIS

Acute mesenteric ischemia (AMI) accounts for approximately 0.09–0.2 % of all emergency hospitalizations in surgical departments. If not diagnosed and treated in a timely manner, the disease is characterized by a high mortality rate (30–70 %). Recent studies have demonstrated the advantages of endovascular intervention over the traditional open approach. The researches note a decrease in mortality rates, frequency of valid intestinal resections, need for total parenteral nutrition, high three-year survival rates (25 %), and low risks of recurrent symptomatic ischemia. The paper presents a clinical case of AMI caused by superior mesenteric artery (SMA) large jejunal branch subocclusion in a patient with mural thrombosis. Based on the data of diagnostic laparoscopy, intestinal necrosis was excluded. The diagnosis was verified by abdominal aorta multispiral computed tomography with intravenous bolus contrast. SMA angiography, transluminal balloon angioplasty of the orifice of the large jejunal artery and the orifice of the ileocolic artery in the Department of X-ray Surgical Diagnostics and Treatment. The postoperative period was uneventful. The patient was discharged under the follow-up care of a surgeon in the home area Despite the recent advances in AMI intensive care, the mortality rate among patients remains consistently high. To achieve a positive result in the treatment of patients with acute vascular bowel diseases, an interdisciplinary approach is needed involving a wide range of specialists, in particular surgeons, specialists in X-ray endovascular diagnostics and treatment, and anesthesiologists-resuscitators. The described clinical case is an example of successful multidisciplinary team work.