Atrial Fibrillation Complicated by Mesenteric and Renal Infarction: Case Report
Published: 2024-07-01
Page: 122-127
Issue: 2024 - Volume 7 [Issue 1]
Mouna Rahmi *
Department of Cardiology, International Hospital University Cheikh Khalifa Casablanca, Morocco.
Amale EL Ouarradi
Department of Cardiology, International Hospital University Cheikh Khalifa Casablanca, Morocco.
Fatima Zahra Merzouk
Department of Cardiology, International Hospital University Cheikh Khalifa Casablanca, Morocco.
Rachida Habbal
Department of Cardiology, International Hospital University Cheikh Khalifa Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: Very rarely, atrial fibrillation can be complicated by acute renal or intestinal infarction. The diagnosis of this condition can therefore be challenging, and treatment guidelines have not yet been established. In this article, we present a case report of a patient with acute mesenteric embolic ischemia and renal infarction as a complication of mitral stenosis-related atrial fibrillation.
Case Report: We report the case of a patient with mesenteric and renal infarction of thromboembolic origin due to rheumatic valvulopathy in atrial fibrillation who presented to the emergency department with acute abdominal pain. The angioscanner showed bilateral renal ischaemia, more extensive on the right, and occlusion of the superior mesenteric artery with signs of visceral distress. An effective dose of anticoagulation was started and an emergency laparotomy was performed, revealing a completely necrotic and distended bowel. The clinical outcome was unfavourable and the patient did not survive.
Conclusion: This case study highlights the importance of diagnosing renal and mesenteric infarction in the presence of acute abdominal pain in patients with embolic heart disease or other risk factors for thrombosis.
Keywords: Atrial fibrillation, mesenteric, renal infarction
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References
Hazanov N, Somin M, Attali M, Beilinson N, Thaler M, Mouallem M. Acute renal embolism. Forty-four cases of renal infarction in patients with atrial fibrillation. Medicine 2004;83:292–9.
Huang CC, Lo HC, Huang HH, Kao WF, Yen DHT, Yen DHT. ED presentations of acute renal infarction. Am J Emerg Med 2007;25:164–9.
Nadeem KA, Shaikh JK, Kalwar MH, Butt MH, Ali, G, Solangi, BA. Incidence of new-onset atrial fibrillation in patients presenting with acute st-elevation myocardial infarction. Journal of Pharmaceutical Research International. 2022 ;34(43A):37–44. DOI: 10.9734/jpri/2022/v34i43A36308.
Saad A, Mahmoud, Ahmed F, Alarag, Randa M, Abdul Mageed, Seham F, Badr. Atrial fibrillation as a predictor of in-hospital outcome in patients with acute Coronary Syndrome Treated by Primary Percutaneous Coronary Intervention. Journal of Advances in Medicine and Medical Research. 2021;33(22):70-84. Available:https://doi.org/10.9734/jammr/2021/v33i2231160.
Zoni-Berisso M, Lercari F, Carazza T, Domenicucci S. Epidemiology of atrial fibrillation: European perspective. Clinical Epidemiology. 2014;213-20.
Suzer O, Shirkhoda A, Jafri SZ, Madrazo BL, Bis KG, Mastromatteo JF. CT features of renal infarction. European journal of radiology. 2002;44(1):59-64.
Antopolsky M, Simanovsky S. Renal infarction in the ED: 10-year experience and review of the literature. Am J Emerg Med. 2012;30:1055–60.
Koivuviita N, Tertti R, Heiro M, Manner I, Metsa¨rinne K. Thromboembolism as a cause of renal artery occlusion and acute kidney injury: the recovery of kidney function after two weeks. Case Rep Nephrol Urol. 2014;4:82–7.
Elalouf V, Vandwalle J. La colique ne´phre´ tique « ische´mique » de l’infarctusrenal : plaidoyer pour la tomodensitome´ trie he´ licoı¨dale syste´matique enurgence. Prog Urol 2011;21:184–90.
Vidart A, Pfister C, Bugel H, Savoye-Collet C, Thoumas D, Grise P. Inte´ reˆt de la tomodensitome´ trie he´ licoı¨dale dans le diagnostic pre´coce de l’infarctus re´ nal. Prog Urol. 2001;11:217–22.
Navaravong L, Ali RG, Giugliano GR. Acute renal artery occlusion: making the case for renal artery revascularization. Cardiovasc Revasc Med. 2011;12:399–402.
Yun WS. Long-term follow-up results of acute renal embolism after anticoagulation therapy. Ann Vasc Surg. 2015;29: 491–5.
Decoste R, Himmelman JG, Grantmyre J. Acute renal infarct without apparent cause: a case report and review of the literature. Can Urol Assoc J. 2015;9:237–9.
Douketis JD, Spyropoulos A, Kaatz S, Becker RC, Caprini JA, Dunn AS. Perioperative bridging anticoagulation in patients with atrial fibrillation. N Engl J Med. 2015;373:823–33.
Schoots IG, Koffeman GI, Legemate DA, Levi M, van Gulik TM. Systematic review of survival after acute mesenteric ischaemia according to disease etiology. Br J Surg. 2004;91:17-27.
Acosta S, Ogren M, Sternby NH. Mesenteric venous thrombosis with transmural intestinal infarction: a population-based study. J Vasc Surg. 2005;41:59-63.
Bayraktar Y, Hamanci O. Etiology and consequences of thrombosis in abdominal vessels. World J Gastroenterol. 2006;12: 1165-74.
Divino CM, Park IS, Angel LP, Ellozy S, Spiegel R, Kim U. A retrospective study of diagnosis and management of mesenteric vein thrombosis. Am J Surg. 2001;181: 20-3.
Henao EA, Bohannon WT, Silva MB. Treatment of portal venous thrombosis with selective superior mesenteric artery infusion of recombinant tissue plasminogen activator.J Vasc Surg. 2003; 38: 1411-5.
Lopera JE, Correa G, Brazzini A, Ustunsoz B, Patel S, Janchai A et al. Percutaneous transhepatic treatment of symptomatic mesenteric venous thrombosis. J Vasc Surg. 2002;36:1058-61.
Takahashi N, Kuroki K, Yanaga K. Percutaneous transhepatic mechanical thrombectomy for acute mesenteric venous thrombosis. J Endovasc Ther. 2005;12: 508-11.
Kim HS, Patra A, Khan J, Arepally A, Streiff MB. Transhepatic catheter-directed thrombectomy and thrombolysis of acute superior mesenteric venous thrombosis. J Vasc Interv Radiol. 2005;16:1685-91.
Preventza OA, Habib FA, Young SC. Portal vein thrombosis: an unusual complication of laparoscopic cholecystectomy. JSLS. 2005;9:87-90.
Swartz DE, Felix EL. Acute mesenteric venous thrombosis following laparoscopic Roux-en-Ygastric bypass. JSLS. 2004;8: 165-9.
Morasch MD, Ebough JL, Chiou AC, Matsumura JS, Pearce WH, Yao JST. Mesenteric venous thrombosis: A changing clinical entity. J Vasc Surg. 2001;34:680-4.
Poultsides GA, Lewis WC, Feld R, Walters DL, Cherry DA, Ruby ST. Portal vein thrombosis after laparoscopic colectomy : thrombolytic therapy via the superior mesenteric vein. Am Surg. 2005;71:856-60.
Cho YP, Jung SM, Han MS, Jang HJ, Kim JS, Kim YH et al. Role of diagnostic laparoscopy in managing acute mesenteric venous thrombosis. Surg Laparosc Endosc PercutanTech. 2003;13:215-7.