We present a case of mesenteric ischemia in a 32-year-old woman. The rarity of this potentially fatal condition in this age group, the diagnostic and therapeutic challenges associated with such a condition, and secondary causes that must always be investigated are highlighted. In this case, activated protein C resistance resulted in thrombosis of the superior mesenteric artery and subsequent bowel ischemia.
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References
1.
Lock G.: Acute mesenteric ischemia—frequently overlooked and often fatal. Med Klin97:402-409, 2002.
2.
Hassett AC, Bontempo FA: Activated Protein C Resistance. Institute for Transfusion Medicine: Transfusion Medicine Update, 2001.
3.
Dahlback B., Carlsson M., Svensson PJ: Familial thrombophilia due to a previously unrecognized mechanism characterized by poor anticoagulant response to activated protein C: Prediction of a cofactor to activated protein C. Proc Natl Acad Sci90:1004-1008, 1993.
4.
Rosendaal FR , Koster T., Vandenbroucke JP, Reitsma PH: High risk of thrombosis in patients homozygous for factor V Leiden (activated protein C resistance). Blood85:1504-1508, 1995.
5.
Murin S., Marelich GP, Arroliga AC, Matthay RA: Hereditary Thrombophilia and Venous Thromboembolism. Am J Respir Crit Care Med158:1369-1373, 1998 .
6.
Dorweiler B. , Neufang A., Kasper-Koenig W., Schinzel H., Schmiedt W., Oelert H.: Arterial embolism to the upper extremity in a patient with factor V Leiden mutation (APC resistance)—a case report and review of the literature. Angiology54:125-130, 2003.
7.
Gomez F., Rodriguez A., Rivas J., Baez JM, Romero S., Marina D.: Mesenteric arterial thrombosis due to activated protein C resistance (factor V Leiden). Surgery128:494-496, 2000.
8.
Kirkpatrick ID, Kroeker MA, Greenberg HM: Biphasic CT with mesenteric CT angiography in the evaluation of acute mesenteric ischemia: initial experience. Radiology229:91-98, 2003.
9.
Pasupathy S. , Sebastian MG, Chia KH: Acute embolic occlusion of the superior mesenteric artery: a report and discussion of management. Ann Acad Med Singapore32:840-842, 2003.
10.
Acosta S., Ogren M., Sternby NH, Bergqvist D., Bjorck M.: Incidence of acute thrombo-embolic occlusion of the superior mesenteric artery—A population-based study. Eur J Vasc Endovasc Surg27:145-150, 2004.
11.
Schoots IG, Koffeman GI, Legemate DA, Levi M., Van Gulik TM: Systematic review of survival after acute mesenteric ischemia according to disease aetiology. Brit J Surg91:17-27, 2004.
