| Objective:To study the clinical and image features of superior mesenteric artery embolism (SMA embolism), in order
to provide timely diagnosis and improve its prognosis.Methods:The clinical and image date of 24 patients treated from July 2011 to
August 2014 were retrospectively reviewed.Results:All cases were complaint of sudden abdominal pain, more were lasting and no
remission (18/24, 75 %), less was pain radiation (1/24, 4.17 %), more accompanied by nausea and vomiting (16/24, 66.67 %), diarrhea
and hematochezia (15/24, 62.5 %). Hyperactive bowel sounds were usually detected in physical examination (19/24, 79.17 %), and few
peritoneal irritation were shown (2/24, 8.33 %). Many patients complicated with hypertension (18/24, 75 %), atrial fibrillation (16/24,
66.67 %), coronary heart disease (14/24, 58.33 %), valvular heart disease (6/24, 25 %) and other peripheral arterial embolism (9/24, 37.5
%). Clinical conforms to the SMA embolismtriad in at least two features in 20 cases (83.33 %), including 13 cases of typical triad (54.17
%). All cases presented truncation or filling defect sign in MSCTA or DSA image (24/24, 100 %), embolism frequently located in first
jejunal artery to ileocolic artery horizontal segment (18/24, 75 %). Distal vessels and branches were usually not developed or developing
sparse (23/24, 95.83 %), and few collateral circulation were shown (3/24, 12.5 %). MSCTA displayed relative density increasing (12/17,
70.59 %), less diameter enlarge (3/17, 17.65 %), fat interval fuzzy (2/17, 11.76 %) of embolism vascular segments. Different levels of
intestinal ischemia were usually detected (15/17, 88.24 %), as well as mesenteric fuzzy or limitation effusion (15/17, 88.24 %), but few
ascites (1/17, 5.82 %).Conclusion:SMA embolism has certain characteristics in clinical and imaging, and MSCTA or DSA should be
applied for the early diagnosis of SMA embolism. |
