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Indian Journal of Surgery

, Volume 81, Issue 4, pp 400–402 | Cite as

Neo-hepato-mesenteric Trunk for Chronic Mesenteric Ischaemia and Ischaemic Hepatic Dysfunction

  • Ashutosh Pandey
  • Abhinaya Reddy
  • Harjeet Singh
  • Ajay SavlaniaEmail author
Case Report
  • 34 Downloads

Abstract

A 48-year-old male diagnosed with classical chronic mesenteric ischaemia along with features of hepatic ischaemia as revealed by low prothrombin time index and contrast computerised tomography (CT) showing small tiny ischaemic fibrotic nodules in liver parenchyma. Computerised tomography angiogram of the abdomen showed occluded celiac artery, superior mesenteric artery and inferior mesenteric artery. Patient required early treatment and the need was to restore blood flow to common hepatic artery and superior mesenteric artery. Open surgical revascularisation was planned considering his young age, longer patency of open bypasses with lesser reintervention rate in follow-up. Patient was optimised by infusion of fresh frozen plasma and injection vitamin K before being taken for surgery. Antegrade supraceliac aorta to common hepatic and superior mesenteric artery bypass was done successfully. Patient developed ascites and elevation of transaminases postoperatively which settled gradually over a week after management with diuretics and albumin infusion. Patient is doing fine at follow-up of more than 16 months.

Keywords

Mesenteric ischaemia Hepatic ischaemia Portal reperfusion Antegrade mesenteric bypass Ascites 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© Association of Surgeons of India 2019

Authors and Affiliations

  • Ashutosh Pandey
    • 1
  • Abhinaya Reddy
    • 1
  • Harjeet Singh
    • 1
  • Ajay Savlania
    • 1
    Email author
  1. 1.Department of General SurgeryPostgraduate Institute of Medical Education and Research(PGIMER)ChandigarhIndia

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