Mesenteric and myocardial ischemia revealing lower limb sarcoma. (December 2021)

• Record Type: Journal Article
• Authors: Jun, Heungman
• Is Part Of: International journal of surgery case reports. Volume 89(2021)
• Publication Date: 2021-12
• Subjects: Mesenteric ischemia -- Leiomyosarcoma -- Embolism; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2021.106616
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction and importance: Although most of the causes of acute superior mesenteric artery (SMA) embolism with a poor clinical course originate from the heart, we report a case of SMA embolism secondary to advanced sarcoma of the lower extremities. Case presentation: A 66-year-old man presented with chest and epigastric discomfort that lasted for 1 day. Coronary angioplasty was performed, followed by laparotomy with an embolectomy of the SMA, small bowel resection, and ileostomy. After surgery, leiomyosarcoma was diagnosed on a biopsy performed in the left thigh, and lung metastasis was confirmed. He had recurrent peritonitis for 2 months and died of multiple organ failure. Clinical discussion: The common etiologies of SMA embolism include cardioembolic sources with atrial fibrillation and recent myocardial infarction. Rare etiologies include atherosclerotic plaque, mural thrombus of the aneurysm, and cardiac sarcoma. Conclusion: Efforts are required for the systemic evaluation of various etiologies in patients with SMA embolism who require rapid diagnosis and intervention. Highlights: Mesenteric ischemia and myocardial ischemia caused by advanced sarcoma of lower extremities are rare. When evaluating patients with SMA embolism, systemic evaluation of various etiologies is required. We present a case of SMA embolism secondary to advanced sarcoma of the lower extremities.