Pulappadi Vishnu Prasad, Poyyamoli Santhosh, Rajkumar Kembai Shanmugam, Mehta Pankaj, Cherian Mathew
Interventional Radiology, Kovai Medical Center and Hospital, Coimbatore, IND.
General Surgery, Kovai Medical Center and Hospital, Coimbatore, IND.
Cureus. 2025 May 24;17(5):e84743. doi: 10.7759/cureus.84743. eCollection 2025 May.
Endovascular stenting is commonly done for chronic mesenteric ischemia (CMI). We report a case of venous congestion in transmesenteric hernia following superior mesenteric artery (SMA) stenting for CMI. A 52-year-old man with a history of extended right hemicolectomy presented with post-prandial abdominal pain for two months. Computed tomography (CT) revealed celiac axis occlusion, high-grade ostial stenosis of the superior and inferior mesenteric arteries, and transmesenteric hernia with volvulus. The patient underwent SMA stenting, and his post-prandial pain resolved. Two days later, he developed right iliac fossa pain. CT revealed the dilatation of mesenteric veins, lymphadenopathy, and fat stranding within the hernia sac, and ascites, suggesting venous congestion and impending strangulation. The patient underwent laparotomy and hernia repair, following which his symptoms resolved.
血管内支架置入术常用于治疗慢性肠系膜缺血（CMI）。我们报告了1例因CMI行肠系膜上动脉（SMA）支架置入术后发生经肠系膜疝静脉淤血的病例。一名有右半结肠扩大切除术病史的52岁男性，出现餐后腹痛2个月。计算机断层扫描（CT）显示腹腔干闭塞、肠系膜上、下动脉起始部高度狭窄以及伴有肠扭转的经肠系膜疝。该患者接受了SMA支架置入术，餐后疼痛缓解。两天后，他出现右下腹疼痛。CT显示肠系膜静脉扩张、淋巴结肿大、疝囊内脂肪密度增高以及腹水，提示静脉淤血和即将发生绞窄。患者接受了剖腹手术和疝修补术，术后症状缓解。
