Abdominal Angina and Intestinal Gangrene-Catastrophic Presentation of Thrombosis of Common Hepato-Spleno-Mesenteric Trunk (HSMT): A Rare Case Report | [Journal of Dow University of Health Sciences • 2019]

Author(s):

1. Marya Hameed: Department of Radiology, Jinnah Postgraduate Medical Center,Karachi,Pakistan

2. Ameet Jesrani: Department of Radiology, Sindh Institute Of Urology and Transplantation,Karachi,Pakistan

3. Aneeta Muhammad: Department of Radiology, Jinnah Postgraduate Medical Center,Karachi,Pakistan

4. Nida Amin Khan: . Department of Radiology, Sindh Institute Of Urology and Transplantation,Karachi,Pakistan

5. Naveed Ahmed: . Department of Radiology, Jinnah Postgraduate Medical Center,Karachi,Pakistan

6. Tariq Mahmood: . Department of Radiology, Jinnah Postgraduate Medical Center,Karachi,Pakistan

Abstract:

Middle age patient was presented in emergency department with complains of acute abdominal pain, vomiting and diarrhea. On clinical examination there was board like rigidity and tender abdomen. Initial labs were unremarkable. Filling defect was seen in an anomalous channel, hepato-spleno-mesenteric trunk that was seen as a supply of liver, spleen, small bowel and part of large bowel on contrast enhanced computed tomography. The left gastric artery was seen arising separately from aorta. Emergency exploratory laprotomy was done. Patchy discoloration and cyanosis with friability was seen in liver and spleen representing ischemia. Gangrene of small bowel and proximal large bowel (till the splenic flexure) was seen. The patient expired few days after presentation. No other surgical intervention was done. This was an unusual case of abdominal angina due to thrombosis of a rare arterial variation of gastrointestinal vascularity. The hepato-spleno-mesenteric trunk was seen thrombosed which happens to be the only artery supplying the midgut and its embryological visceral derivatives in the subjects it occur in. However, in cases like these there is a possibility of collateral supply from esophageal, phrenic and inferior mesenteric arteries.

Page(s): 171-173

DOI: DOI not available

Published: Journal: Journal of Dow University of Health Sciences, Volume: 13, Issue: 3, Year: 2019

Keywords:

abdominal agina , hepatosplenomesentric trunk

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