Introduction: Acute mesenteric ischemia due to an embolism of the superior mesenteric artery (SMA) is associated with a high mortality rate. Over twenty per cent of acute mesenteric embolism cases consist of multiple emboli. Case Presentation: We present a rare case of a 62-year-old man admitted with acute abdominal pain and signs of intestinal occlusion related to an acute mesenteric ischemia due to superior mesenteric arterial embolism. It was associated with a synchronous acute bilateral lower limb ischemia due to embolic arterial occlusion. He underwent an emergency explorative laparotomy with proximal jejunal resection, and the patient made an excellent recovery. As for the acute limb ischemia, it was treated by efficient anticoagulation allowing limb salvage. Conclusion: When treating a superior mesenteric arterial embolism, the possibility of recurrent or multiple arterial thromboembolic events should be considered. A prompt diagnosis, aggressive surgical treatment and intensive care could improve the prognosis.
Bradbury, A.W., Brittenden, J., McBride, K. and Ruckley, C.V. (1995) Mesenteric Ischaemia: A Multidisciplinary Approach. British Journal of Surgery, 82, 1446-1459. http://dx.doi.org/10.1002/bjs.1800821105
Sitges-Serra, A., Mas, X., Roqueta, F., Figueras, J. and Sanz, F. (1988) Mesenteric Infarction: An Analysis of 83 Patients with Prognostic Studies in 44 Cases Undergoing a Massive Small-Bowel Resection. British Journal of Surgery, 75, 544-548. http://dx.doi.org/10.1002/bjs.1800750614
Yamada, et al. (2012) Upper Limb Amputation Due to a Brachial Arterial Embolism Associated with a Superior Mesenteric Arterial Embolism: A Case Report. BMC Research Notes, 5, 372. http://dx.doi.org/10.1186/1756-0500-5-372
Wooyul, P., Mi-Kyeong, O., Jee-Hun, K., Ha-Gyoung, K. and Sang-Sig, C. (2011) Paroxysmal Atrial Fibrillation Presenting as Acute Lower Limb Ischemia. Korean Journal of Family Medicine, 32, 423-427. http://dx.doi.org/10.4082/kjfm.2011.32.7.423