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An unusual cause of acute mesenteric ischaemia
  1. Giovanni Perricone1,2,
  2. Rosa G Simonetti3
  1. 1Hepatology and Gastroenterology Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
  2. 2Liver Failure Group, University College London, UCL Institute for Liver and Digestive Health, UCL Medical School, Royal Free Hospital, London, UK
  3. 3Palermo, Italy
  1. Correspondence to Dr Giovanni Perricone, Hepatology and Gastroenterology Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano 20162, Italy; giovanniperricone{at}gmail.com

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Clinical introduction

A 50-year-old woman, smoker, with a body mass index of 29 kg/m2, presented to the emergency department with a history of sudden-onset abdominal pain localised to the left hypochondrium and the left lumbar region. The pain was severe, sharp and constant, and was associated with nausea and vomiting. Physical examination revealed tenderness in the left upper quadrant and epigastrium and hypoactive bowel sounds. Blood tests revealed leucocytosis (17.5×109/L). An abdominal CT with intravenous contrast showed acute mesenteric ischaemia. An ECG and cardiac monitoring showed normal sinus rhythm, and a transthoracic two-dimensional echocardiogram showed no evidence of general cardiac pathology or valvular heart disease, excluding a cardiac source of emboli. A CT …

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