• Mihail Cotorogea-Simion, Sebastian Isac, Alina Tita, Letitia Toma, Laura Elena Iliescu, Adriana Mercan-Stanciu, Teodora Isac, Anca Bobirca, Florin Bobirca, Cristian Cobilinschi, Maria Daniela Tanasescu, and Gabriela Droc.
• Department of Anesthesiology and Intensive Care I, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania.
• Medicina (Kaunas). 2022 Aug 24; 58 (9).

IntroductionChronic mesenteric ischemia is a rare entity with non-specific symptomatology; combined with rare etiologies, it could lead to unwarranted surgical indication.Case ReportWe report the case of an 85-year-old woman, with a history of hypertension, persistent thrombocytosis, atherosclerosis, and recent minor COVID-19 infection, presenting to the hospital with postprandial abdominal pain and nonspecific clinical examination findings; upon abdominal CT, superior mesenteric artery circumferential thrombosis was revealed. A bone marrow biopsy was performed due to suspected essential thrombocythemia, confirming the diagnosis. An endovascular approach was chosen as therapy option and a stent was placed in the occluded area. Dual antiplatelet and cytoreductive therapies were initiated after the intervention. Clinical course was excellent, with no residual stenosis 1 month after stenting.ConclusionsThe therapeutic strategy in elderly patients with exacerbated chronic mesenteric ischemia requires an interdisciplinary approach in solving both the exacerbation and the underlying conditions in order to prevent further thrombotic events. Although the patient presented a thrombotic state, other specific risk factors such as COVID-19 related-coagulopathy and essential thrombocythemia should be considered.

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