Ding P, Zhou Y, Long KL, Zhang S, Gao PY. Acute mesenteric ischemia due to percutaneous coronary intervention: A case report. World J Clin Cases 2022; 10(28): 10244-10251 [PMID: 36246830 DOI: 10.12998/wjcc.v10.i28.10244]
Corresponding Author of This Article
Pei-Yang Gao, MD, Chief Physician, Professor, Department of Critical Care Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shierqiao Road, Jinniu District, Chengdu 610072, Sichuan Province, China. gaopy930@126.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 6, 2022; 10(28): 10244-10251 Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10244
Acute mesenteric ischemia due to percutaneous coronary intervention: A case report
Peng Ding, Yuan Zhou, Kun-Lan Long, Song Zhang, Pei-Yang Gao
Peng Ding, Kun-Lan Long, Song Zhang, Pei-Yang Gao, Department of Critical Care Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, China
Yuan Zhou, Department of Geriatrics, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
Author contributions: Ding P collected case data and wrote the manuscript; Zhou Y prepared the photos; Long KL, Zhang S and Gao PY proofread and revised the manuscript; all authors approved the final version to be published.
Informed consent statement: Informed consent was obtained from the patient's son for publication of the case report and accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pei-Yang Gao, MD, Chief Physician, Professor, Department of Critical Care Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shierqiao Road, Jinniu District, Chengdu 610072, Sichuan Province, China. gaopy930@126.com
Received: May 21, 2022 Peer-review started: May 23, 2022 First decision: June 16, 2022 Revised: July 1, 2022 Accepted: August 24, 2022 Article in press: August 24, 2022 Published online: October 6, 2022 Processing time: 129 Days and 5.5 Hours
Abstract
BACKGROUND
Percutaneous coronary intervention (PCI) is extensively used to treat acute coronary syndromes (ACS). Acute mesenteric ischemia is a life-threatening disease if untreated.
CASE SUMMARY
An 81-year-old female presented with 3 d of lethargy and 1 d of dyspnea. On November 16, 2021, the patient developed a coma. Her oxygen saturation dropped to 70%-80%, the patient was admitted to the intensive care unit for further treatment. Chest computed tomography (CT) showed chronic bronchitis, emphysema, and multiple lung infections. Abdominal CT scan showed no obvious abnormalities, but have severely calcified abdominal vessels. The patient received assisted ventilation, and vasoactive, and anti-infection drugs. Troponin level was elevated. Since the patient was in a coma, it could not be determined whether she had chest pain. The cardiologist assumed that the patient had developed ACS; therefore, the patient underwent PCI via the left femoral artery approach, and no obvious abnormalities were found in the left and right coronary arteries. On the second postoperative day, the patient presented with abdominal distension and decreased bowel sounds; constipation was considered and a glycerin enema was administered. On day 4, the patient suddenly lost consciousness, and had decreased blood pressure, abdominal wall swelling with increased tension, and absence of bowel sounds. An urgent abdominal CT scan revealed gas in her hepatic portal system with extensive bowel wall necrosis. The patient died on day 5 due to intractable shock.
CONCLUSION
The potential serious complications in patients undergoing PCI, especially the patients who are hemodynamically unstable and have severely calcified abdominal vessels, should all be considered.
Core Tip: Acute mesenteric ischemia (AMI) is a life-threatening condition. The etiology is mostly the emboli from the heart or thrombosis of atherosclerotic vessel walls involving the superior mesenteric artery. To date, AMI after percutaneous coronary intervention (PCI) has rarely been reported. Here we report a case of AMI after PCI. For hemodynamically unstable patients with sudden abdominal pain after PCI, AMI should be considered.
