Superior Mesenteric Artery Thrombosis and Intestinal Ischemia in Chronic Kidney Disease

Abstract

We describe the case of an elderly female with a complex medical history, including hypertension, chronic kidney disease, hypothyroidism, and multiple cardiovascular and pulmonary conditions, who presented to the emergency department with abdominal pain. Due to the patient’s chronic kidney disease, two non-contrast CT scans initially ordered showed unremarkable results. The decision to order a third CT scan with contrast finally demonstrated a thrombus in the superior mesenteric artery with potential bowel ischemia. The patient’s condition deteriorated rapidly during the discovery of mesenteric artery thrombosis and extensive gangrenous bowel during surgery. Due to the irreversibility of the bowel ischemia, the patient was placed on comfort measures and passed away.