Department of Cardiology, Tianjin First Central Hospital, No. 24, Fukang Road, 300192, Tianjin, China.
Department of Anesthesiology, Tianjin First Central Hospital, No. 24, Fukang Road, Tianjin, 300192, China.
BMC Cardiovasc Disord. 2023 Jan 30;23(1):56. doi: 10.1186/s12872-023-03066-5.
Superior mesenteric artery embolism (SMAE) is a rare cause of acute abdomen, and the fatality rate is extremely high if it is not diagnosed and treated in time. Due to the lack of knowledge and experience of nonspecialist physicians, it is easy to misdiagnose. Radiofrequency ablation (RFA) has become the first-line treatment strategy for atrial fibrillation (AF). Thromboembolic events are some of the major complications after RFA, whereas SMAE is rarely reported.
A 70 year-old woman with paroxysmal AF who regularly took anticoagulant drugs for 3 months experienced abdominal pain after RFA. At the outset, she was misdiagnosed as mechanical intestinal obstruction. When the patient presented with blood in the stool, abdominal enhancement computed tomography was conducted and showed a small bowel perforation. Immediate laparotomy was performed, and the final diagnosis was SMAE.
It is suggested that for unexplained abdominal pain after RFA of AF, the possibility of SMAE should be considered, and a targeted examination should be carried out in time to confirm the diagnosis and give appropriate treatment.
肠系膜上动脉栓塞（SMAE）是急性腹痛的罕见原因，如果不能及时诊断和治疗，死亡率极高。由于非专科医生缺乏相关知识和经验，很容易误诊。射频消融（RFA）已成为心房颤动（AF）的一线治疗策略。血栓栓塞事件是 RFA 后的主要并发症之一，而 SMAE 则很少见报道。
一名 70 岁女性，阵发性 AF，规律抗凝治疗 3 个月，RFA 后出现腹痛。起初，她被误诊为机械性肠梗阻。当患者出现血便时，进行了腹部增强 CT 检查，显示小肠穿孔。立即行剖腹探查术，最终诊断为 SMAE。
对于 AF 的 RFA 后不明原因的腹痛，应考虑 SMAE 的可能性，并及时进行针对性检查以明确诊断并给予适当治疗。
