Abstract
A 67-year-old male presented to us with symptoms of postprandial abdominal pain for the last 3 months and was not able to take meals for the last month. The computed tomography (CT) angiogram showed complete occlusion in the coeliac artery (CA), superior mesenteric artery (SMA) and inferior mesenteric artery (IMA) with complete occlusion of infrarenal aorta and bilateral iliac arteries. While waiting for elective surgical mesenteric bypass, patient suddenly developed signs of peritonitis for which emergency surgery was done using a Dacron bifurcated graft 12 × 6 mm size. Inflow was taken from the supra coeliac aorta. At 6 months follow-up, the patient was doing well and the CT angiogram showed a patent graft. In our case, the challenge was from where to take inflow, as the patient’s aorta was atherosclerotic and infrarenal aorta was completely occluded, and he was also not suitable for endovascular stenting. So, we decided to take inflow from the supra coeliac aorta and a distally mesenteric bypass was done. Although mesenteric ischaemia has very high morbidity and mortality rates, prompt and well-planned mesenteric bypass surgery can save both bowel and patients life as well.
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SP and DM prepared the primary draft, Images by PG and AM, Revised by MK, AKS, and SP. All authors contributed to the final draft and approved the final draft.
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As this is a single-case study, ethical waiver was granted by the institutional ethical committee (IEC AIIMS Jodhpur).
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This case was presented as an oral presentation (free paper) by Surendra Patel at “The 70th Annual Conference of the Indian Association of Cardiovascular Thoracic Surgeons, held on 08–11 February 2024, at Mayfair Lagoon, Bhubaneshwar, India”.
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Patel, S., Meena, D., Garg, P. et al. Surgical bypass of superior and inferior mesenteric arteries with Dacron graft in a patient with acute on chronic mesenteric ischaemia with atherosclerotic complete occlusion of the infrarenal aorta. Indian J Thorac Cardiovasc Surg (2024). https://doi.org/10.1007/s12055-024-01730-9
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DOI: https://doi.org/10.1007/s12055-024-01730-9