ACR AC Portal

Home Radiologic Management of Mesenteric Ischemia

Variants

Previously healthy with worsening diffuse abdominal pain for 2 weeks. CTA shows occlusion of the superior mesenteric vein and its major tributaries. Bowel appears normal. Serum lactate level is normal. Initial therapy.

Documents

Narrative
Evidence Table
Lit Search
Appendix

Scenario

Scenario ID

Procedure

Adult RRL

Peds RRL

Appropriateness Category

Previously healthy with worsening diffuse abdominal pain for 2 weeks. CTA shows occlusion of the superior mesenteric vein and its major tributaries. Bowel appears normal. Serum lactate level is normal. Initial therapy.

3195698

Systemic anticoagulation

Usually appropriate

Transhepatic superior mesenteric vein catheterization and pharmacomechanical thrombolysis

Usually appropriate

Transjugular superior mesenteric vein catheterization and pharmacomechanical thrombolysis and TIPS

May be appropriate

SMA angiography followed by thrombolytic infusion

May be appropriate

Surgical thrombectomy

Usually not appropriate