Abdominal pain following percutaneous mitral valve repair (MitraClip)

Clinical presentation An 81-year-old man underwent percutaneous mitral valve repair (MitraClip) due to severe symptomatic mitral valve regurgitation. Coronary heart disease was excluded prior to mitral valve repair. Approximately 8 h after the uneventful and successful intervention, the patient presented with progressive abdominal pain, in particular tenderness in the right upper quadrant with guarding. Laboratory tests did not reveal any acute alterations; serum lactate was 2.4 mmol/L. Bedside ultrasonography showed a distended ascending colon with a pronounced hyperechoic large bowel wall (figure 1A). Native CT imaging was performed (figure 1B). The patient subsequently underwent emergency laparotomy. Question What is the correct imaging diagnosis and the underlying condition? See page 494 for answer See page 458 for question Answer Ultrasonography and CT imaging revealed pneumatosis intestinalis (PI) of the ascending colon (figure 1A, B); however, no hepatic portal venous gas was...

Source: Gut - February 3, 2015 Category: Gastroenterology Authors: Neesse, A., Nimphius, W., Schoppet, M., Gress, T. M. Tags: GUT Snapshot Editor ' s quiz: GI snapshot Source Type: research