TAILIEUCHUNG - báo cáo khoa học: " A rare cause of chronic mesenteric ischemia from fibromuscular dysplasia: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: A rare cause of chronic mesenteric ischemia from fibromuscular dysplasia: a case report | Senadhi Journal of Medical Case Reports 2010 4 373 http content 4 1 373 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access A rare cause of chronic mesenteric ischemia from fibromuscular dysplasia a case report Viplove Senadhi Abstract Introduction Chronic mesenteric ischemia is a condition that is classically associated with significant atherosclerosis of the abdominal arteries causing postprandial abdominal pain out of proportion to physical examination. The abdominal pain is exacerbated after meals due to the shunting of blood away from the intestines to the stomach causing relative ischemia. More than 95 of chronic mesenteric ischemia cases are due to atherosclerosis. We report the first known case of chronic mesenteric ischemia from fibromuscular dysplasia. To the best of our knowledge this is also the first known case in the literature where postprandial abdominal pain was the presenting symptom of fibromuscular dysplasia. Case presentation A 44-year-old Caucasian woman with a history of hypertension and preeclampsia who had taken oral contraceptive pills for 15 years presented with an intractable colicky abdominal pain of two weeks duration. This abdominal pain worsened with oral intake. It was also associated with diarrhea and vomiting. Physical examination revealed stage III hypertension out of proportion to her risk factors and diffuse abdominal pain without peritoneal signs. An abdominal computed tomography scan completed in the emergency room revealed nonspecific colitis. Laboratory work revealed leukocytosis with a left shift an erythrocyte sedimentation rate of 79 and a C-reactive protein level of 100. She was started on intravenous flagyl and intravenous ciprofloxacin. However all microbial cultures were negative including three cultures for clostridium difficile. Urine analysis revealed nephritic range proteinuria. The laboratory profile was within normal limits for perinuclear-anti-neutrophil cytoplasmic .

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