Embolic Occlusion of the Inferior Mesenteric Artery Is a Cause of Ischaemic Colitis.

A 66 year old male with acute lower limb ischaemia Rutherford IIA, due to femoroperoneal bypass thrombosis, was treated by catheter directed thrombolysis using a crossover 8 French sheath with low dose heparin. Despite 48 hours of thrombolysis, and a novel attempt at endovascular recanalisation, the bypass remained occluded. Meanwhile, the patient experienced respiratory failure. The chest Xray revealed a pneumoperitoneum (A, arrow). This was caused by grade III ischaemic colitis and confirmed by computed tomography angiography also noting an inferior mesenteric artery occlusion caused by an aortic thrombus (B, asterisk, arrow). He underwent a Hartmann procedure, and later transfemoral amputation.