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Vascular » Visceral vascular
Proximal superior mesenteric artery occlusion
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Author(s) :
Jim Mosley, RVT, RDMS
 
Presentation A middle aged male presented to the radiology department with severe abdominal discomfort. His pain had been present for an extended period of time with loss of appetite and weight loss.
 
 
 
Caption: Longitudinal image left of midline, subxiphoid.
Description: Flow void noted in proximal superior mesenteric artery, despite optimal Doppler settings.
 
 
 
Caption: Spectral analysis in the mid SMA.
Description: Spectral Doppler waveform reveals dampened arterial signal suggesting severe proximal stenosis.
 
 
 
Caption: Spectral Doppler of celiac axis.
Description: Spectral Doppler of celiac axis shows acceptable waveform with minor respiratory artifact.
 
 
 
Caption: Angiogram of aortic branches.
Description: Angiogram of messenteric vessels suggests proximal superior messenteric artery occlusion with reconstitution via celiac axis collaterals.
 
Differential Diagnosis Severe proximal superior mesenteric artery stenosis.
 
Final Diagnosis Proximal superior mesenteric artey occlusion with reconstitution via celiac axis collaterals.
 
Follow Up The patient was seen by a vascular surgeon the morning of  the ultrasound and angiographic evaluation. He was then taken to surgery and the superior mesenteric artery occlusion was corrected.
 
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