TY - CHAP M1 - Book, Section TI - ACUTE MESENTERIC ISCHEMIA A1 - Wang, John C. A1 - Kashyap, Vikram S. A2 - Dean, Steven M. A2 - Satiani, Bhagwan A2 - Abraham, William T. Y1 - 2015 N1 - T2 - Color Atlas and Synopsis of Vascular Diseases AB - A 74-year-old hypertensive male presents with a four-hour history of acute-onset severe diffuse abdominal pain. Two weeks prior he was hospitalized with a large anterior wall MI complicated by intermittent atrial fibrillation. Due to a history of frequent falls, he was not anticoagulated. Physical examination is remarkable for an uncomfortable individual with an irregularly irregular heart rhythm and a minimally tender abdomen without peritoneal signs. Laboratory assessment is remarkable for a leukocytosis of 14,000 and mild metabolic acidosis. Electrocardiography indicates atrial fibrillation with a rapid ventricular response between 120 and 140 beats/minute. CT scan of the abdomen illustrates a distended small bowel and a questionable filling defect within the superior mesenteric artery (SMA). Mesenteric arteriography displays a "mercury meniscus sign" within the SMA 4 cm from the aorta. A diagnosis of cardioembolic acute mesenteric ischemia is made and the patient is immediately taken to the operating suite. SN - PB - McGraw-Hill Medical CY - New York, NY Y2 - 2024/03/28 UR - accesscardiology.mhmedical.com/content.aspx?aid=1105290995 ER -