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case_images: Abdominal tomography showing the 5mm hypotension nodule in the duodenal ampulla.
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case_images: Abdominal tomography with contrast showed a hypodense nodule in the duodenal ampulla measuring 5 mm (Figure 1).
case_images: Angiotomography of the abdominal aorta and branches, showing occlusion of the celiac trunk with distal filling via collaterals, and critical stenosis of the superior mesenteric artery and inferior mesenteric artery.
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case_images: There was occlusion of the celiac trunk (CTr), but with distal refilling via collaterals, occlusion of the inferior mesenteric artery and critical SMA stenosis, which had a 1mm lumen (Figure 2).
case_images: Upper digestive endoscopy showing multiple, bleeding, superficial ulcers with irregular margins and areas of pallor.
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case_images: A hypothesis of carcinoma of the duodenal ampulla or biliary ducts was ventured and she underwent an upper digestive endoscopy (UDE), demonstrating multiple superficial gastric ulcers with irregular margins and bleeding along the body of the stomach, with areas of pallor, suggestive of ischemic gastritis, and normal duodenal papilla (Figure 3).
case_images: Angioplasty of the superior mesenteric artery with a covered balloon-expandable stent.
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case_images: Endovascular treatment was scheduled to perform SMA angioplasty with a V12 6 x 38 mm stent (Figure 4) via a left brachial access.
case_images: Control endoscopy showing healed ulcers and moderate pangastritis.
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case_images: At 30 days, UDE was performed, showing healed ulcers and moderate pangastritis (Figure 5), and control angiotomography showed a patent stent (Figure 6A).
case_images: (A) Control angiotomography at 30 days, showing patent stent; and (B) control angiotomography at 6 months, with patent stent.
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case_images: At 30 days, UDE was performed, showing healed ulcers and moderate pangastritis (Figure 5), and control angiotomography showed a patent stent (Figure 6A). She has gained 10 kg in weight and the mesenteric stent remains patent and free from stenosis (Figure 6B).