A.Kh. ODINTSOVA¹, N.A. CHEREMINA¹, R.A. ZEFIROV¹, R.M. AKHMETZIANOV¹, E.S. BODRIAGINA², A.V. DOBRYNINA², A.V. POSTNIKOV¹

¹Republican Clinical Hospital of the MH of RT, Kazan

²Kazan State Medical University, Kazan

 Contact:

Odintsova A.Kh. ― PhD (medicine), Head of the Gastroenterology Department

Address: 138 Orenburgskiy trakt, Kazan, Russian Federation, 420164, tel. (843) 231-21-78, e-mail: [email protected]

Objective ― to present the clinical case of intestinal ischemia and the differential diagnosis of abdominal pain syndrome.

Material and methods. Patient S., male, 58 years old, was hospitalized in the Gastroenterology Department with complaints of abdominal pain, diarrhea, increased blood pressure, weakness.

Results. From the anamnesis it was clear that abdominal pain appeared a month ago. Inflammatory changes in the terminal ileum and colon were diagnosed, than peritonitis developed, surgical intervention was provided. These changes were regarded to be Crohn’s disease, but during computed tomography of the abdomen signs of mesenteric thrombosis were detected. For further treatment, the patient was hospitalized to the Surgical Department, mesenteric artery stenting and complex antithrombotic therapy were performed. In the postoperative period, the patient’s condition improved, the abdominal pain decreased.

Conclusion. Abdominal pain in patients with identified inflammatory changes in the intestine may also be a symptom of intestinal ischemia, which requires additional research methods when failure of conservative therapy.

Key words: intestinal ischemia, thrombophilia, abdominal pain.

(For citation: Odintsova A.Kh., Cheremina N.A., Zefirov R.A., Akhmetzianov R.M., Bodriagina E.S., Dobrynina A.V. Clinical case of intestinal ischemia. Practical medicine. 2019. . 2019. Vol. 17, № 6 (part 1), P. 88-90)

REFERENCES

1. Kalinin A.V., Stepuro D.K., Korneev N.V. et al. Chronic abdominal ischemic syndrome and diseases associated with it: clinical features, diagnosis and treatment. Klinicheskie perspektivy gastroenterologii, gepatologii, 2003, no. 6, pp. 19-23 (in Russ.).
2. Mirolyubov B.M. Angiopatologiya i osnovy sosudistoy khirurgii. Uchebnoe posobie [Angiopathology and the basics of vascular surgery. Tutorial]. Kazan: KGMU, 2011. 148 p. Pp.101-105.
3. Yaroshchuk S.A., Baranov A.I., Katasheva L.Yu., Leshchinin Ya.M. Acute mesenteric ischemia: approaches to diagnosis and surgical treatment. Meditsina v Kuzbasse, 2018, vol. 17, no. 2, pp. 35-42 (in Russ.).
4. Ullah W., Mukhtar M., Abdullah H.M.A. et al. Diagnosis and Management of Isolated Superior Mesenteric Artery Dissection: A Systematic Review and Meta-Analysis. Korean Circ. J, 2019, no. 49 (5), pp. 400-418.
5. Van Dijk L. JD, van Noord D., de Vries A. et al. Clinical management of chronic mesenteric ischemia. United European Gastroenterology Journal, 2019, vol. 7 (2), pp. 179-188.
6. Caluwaerts M., Castanares-Zapatero D., Laterre P.-F., Hantson P. Prognostic factors of acute mesenteric ischemia in ICU patients. BMC Gastroenterology, 2019, 19, 80.