Caption: Figure 5: CT abdomen and pelvis showed prominent bowel loops with wall thickening, suggestive of bowel ischemia
The aim of anticoagulation is to prevent propagation of the thrombosis and further complications such as portal hypertension and bowel ischemia
and to attain portal vein patency.
Hospital, all patients suspected of having bowel ischemia
were included immediately when tested positive for at least one of the following inclusion criteria:
Initial conservative medial management with anticoagulation and close follow-up can be applied in the absence of bowel ischemia
or vessel rupture.
This disease is difficult to diagnose presymptomatically; therefore most cases present as spontaneous intraabdominal hemorrhage, and a few cases appear as bowel ischemia
, hematuria, or hemobilia.
Given the fact that our patient later presented with bowel ischemia
necessitating surgery, an incomplete reduction must be considered as a causative factor.
Patients with symptoms (e.g., abdominal peritonitis and systemic toxic symptoms) of advanced bowel ischemia
or bowel necrosis evidenced by CTA observations (e.g., with air bubble sign but without intestinal wall contrast enhancement on CTA images) were excluded.
Other complications include bowel ischemia
, fistulization, and metal toxicity from coin ingestion (6).
Severe inflammation and vasculitis may predispose to bowel ischemia
, with perforation and peritonitis as possible sequelae.
Interestingly, the symptoms of small bowel ischemia
are likely to manifest rather than ischemia colitis, while the "culprit vessel" is often found as IMA.
Gastrointestinal (GI) complications such as bowel ischemia
are also not very common.
Gastrointestinal involvement may manifest as nausea, vomiting, abdominal pain, transient paralytic ileus, hemorrhage, bowel ischemia
, intussusception (rare in adults), and / or bowel perforation.
* Bowel ischemia
is usually characterized by diffuse pain, diarrhea, and a positive lactate test.
A dreadful outcome of intestinal obstruction is strangulation leading to bowel ischemia
, necrosis and ultimately perforation.