Medical Quiz acute mesenteric ischaemia

ABSTRACT

A 62 years old Bahraini man was admitted through the surgical clinic with recurrent attacks os central abdominal pain of several month's duration. He gave a history of ischaemic heart disease but was not on regular treatment. Previous echocardiography had shown impaired systolic left ventricular function with global hypokinesia. On the second day of his admission he developed a cold left lower limb. Clinical examination revealed an absent pulse from dorsalis pedis and posterior tibial arteries that was confirmed by duplex ultrasound. Following a femoral angiography [Fig. 1] he underwent a successful femoral embolectomy. On the first postoperative day he complained of severe central abdominal pain and became hypotensive and tachycardiac