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- W2911419005 abstract "Acute mesenteric ischemia is a life-threatening condition that occurs when an abrupt decrease in blood flow results in inadequate supply to the intestines, leading to bowel infarction. Etiologies may include arterial embolus, arterial or venous thrombosis, and nonocclusive mesenteric ischemia. Other causes include vasculitis, traumatic injury, dissection of the aorta and intestinal obstruction. Nonbacterial thrombotic endocarditis (NBTE) is a rare condition that refers to a spectrum of noninfectious lesions of the heart valves. It is often an autopsy finding, found in approximately 1%-1.5% of adults during autopsy. We herein present a case of a 42 year-old male patient with a significant history of smoking presented with a new onset diffuse abdominal pain of 2 days prior to admission. Physical exam was unremarkable. CBC and CMP did not reveal any abnormalities. CT angiography of the abdomen visualized a superior mesenteric artery (SMA) thrombus. The patient underwent an emergent exploratory laparotomy with SMA thrombectomy and endarterectomy and resection of 285 cm of small bowel. Workup for coagulopathy, systemic lupus erythematosus (SLE) and antiphospholipid syndrome was nondiagnostic. Transthoracic echocardiogram showed a small mobile structre attached to the aortic valve, so transesophageal echocardiogram was done and showed a freely mobile pedunculated homogenous mass that is attached to the sub valvular aortic area. Patient underwent thoracotomy and the vegetation was excised. Surgical histopathology was consistent with fibrinous thrombus and no evidence of infective organisms. The patient was started on low molecular weight heparin, then transitioned to rivaroxaban. Acute mesenteric ischemia is a lifethreatening disease, with mortality rates that can approach 90% in the setting of bowel infarction. As such, it is important to establish an early diagnosis before the onset of bowel infarction. Thorough history, physical exam and workup should be done to identify the cause of mesenteric ischemia. Nonbacterial thrombotic endocarditis is characterized by the deposition of sterile platelet thrombi on heart valves, commonly aortic and mitral. It is mostly associated with advanced malignancies (80 percent of cases) and systemic lupus erythematosus (SLE). Although it is rare, it should be kept in mind as an important cause of acute mesenteric ischemia.Figure: CT Scan Showing SMA Occlusion.Figure: Homogeneous Mass Attached To The Subvalvular Aortic Area (Systole).Figure: Homogeneous Mass Attached To The Subvalvular Aortic Area (Diastole)." @default.
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- W2911419005 date "2017-10-01" @default.
- W2911419005 modified "2023-10-14" @default.
- W2911419005 title "An Interesting Case of Acute Mesenteric Ischemia Secondary to Non-bacterial Thrombotic Endocarditis" @default.
- W2911419005 doi "https://doi.org/10.14309/00000434-201710001-02470" @default.
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