A 66-year-old man went to the hospital with severe stomach pain after eating raw fish. Doctors initially thought he had a parasitic infection from the fish, but testing revealed something much more serious: a blood clot had blocked a major artery supplying his intestines. The real culprit was an irregular heartbeat he didn’t know he had. Doctors successfully removed the clot using a minimally invasive procedure and a special stent, and the patient recovered well. This case teaches doctors to consider multiple possibilities when patients have sudden severe abdominal pain, especially when initial tests don’t match the suspected diagnosis.
The Quick Take
- What they studied: How a serious but rare condition (a blood clot blocking the main artery to the intestines) was mistaken for a common food-related illness and what doctors learned from this case
- Who participated: One 66-year-old male patient who presented to the emergency room with severe upper stomach pain after eating raw fish
- Key finding: A blood clot in the main intestinal artery was successfully diagnosed and treated with a minimally invasive procedure, but only after doctors realized the patient’s irregular heartbeat was the underlying cause
- What it means for you: If you experience severe sudden stomach pain, especially after eating raw fish, doctors should consider multiple possible causes rather than assuming the most obvious one. This case highlights the importance of thorough testing and considering heart rhythm problems as a potential cause of intestinal emergencies.
The Research Details
This is a case report, which means doctors documented and analyzed the medical history of a single patient to teach other healthcare providers about an unusual or instructive situation. The patient came to the emergency room with severe pain in the upper abdomen after eating raw fish. Because raw fish can sometimes contain parasites that cause a condition called anisakiasis, doctors initially suspected this diagnosis and performed an endoscopy (a camera test to look inside the stomach). However, instead of finding a parasite, they discovered that the patient’s intestines weren’t getting enough blood flow, suggesting a blocked artery. Further testing revealed the patient had an irregular heartbeat called atrial flutter that he didn’t know about, which had caused a blood clot to form and travel to the main artery supplying the intestines.
This case is important because it shows how a serious, life-threatening condition can be hidden behind symptoms that look like a more common problem. By documenting this case, doctors can learn to think more broadly when patients don’t respond as expected to initial diagnoses. The case also demonstrates how an undiagnosed heart rhythm problem can lead to dangerous complications in other parts of the body.
As a single case report, this study provides detailed information about one patient’s experience but cannot prove that these findings apply to many people. Case reports are most valuable for teaching doctors about unusual presentations of diseases and for raising awareness about diagnostic possibilities. The strength of this case lies in the clear documentation of how the diagnosis was made and how the patient was successfully treated.
What the Results Show
The patient’s severe stomach pain was caused by a blood clot blocking the superior mesenteric artery (SMA), which is the main blood vessel that supplies the small intestines. The blockage was successfully treated using endovascular therapy, a minimally invasive procedure where doctors insert a catheter (thin tube) through blood vessels and place a self-expandable stent (a small metal mesh tube) to restore blood flow. The patient’s symptoms improved significantly after this procedure. Following the stent placement, doctors performed an additional surgical procedure called laparoscopic partial jejunectomy to remove a section of the small intestine that had been damaged by the lack of blood flow. After these treatments, the patient was able to eat a normal diet and was discharged from the hospital in good condition.
The discovery of previously undiagnosed atrial flutter (an irregular heartbeat) was crucial to understanding why the blood clot formed. This finding suggests that the patient’s heart rhythm problem had been present but undetected before this emergency. The case also demonstrates that endoscopy, while useful for detecting parasitic infections, can reveal other serious conditions like intestinal ischemia (lack of blood flow to the intestines) when doctors look carefully at what they see.
Acute mesenteric artery occlusion (blockage of the main intestinal artery) is a known medical emergency that is often difficult to diagnose quickly because its symptoms can mimic other conditions. This case adds to the medical literature by showing a specific scenario where the presentation mimicked a parasitic infection, potentially delaying diagnosis. Previous research has established that atrial flutter increases the risk of blood clots, but this case illustrates how that risk can manifest as an intestinal emergency rather than the more commonly recognized stroke risk.
This is a single case report involving one patient, so the findings cannot be generalized to larger populations. The case does not provide information about how common this particular combination of circumstances might be. Additionally, the case report does not include long-term follow-up data beyond the patient’s discharge, so we don’t know about the patient’s long-term outcomes or quality of life after treatment. The report also doesn’t provide detailed information about the patient’s medical history before this event, which could have provided additional context.
The Bottom Line
This case suggests that doctors should maintain a high index of suspicion for mesenteric artery blockage in patients presenting with severe sudden abdominal pain, even when initial findings suggest a different diagnosis. Patients with newly discovered or known atrial flutter should be aware of the increased risk of blood clots and should follow their doctor’s recommendations for anticoagulation therapy (blood thinners). If you experience severe sudden abdominal pain, especially after eating raw fish, seek emergency medical care immediately and ensure doctors perform comprehensive testing rather than relying on a single diagnosis.
This case is particularly relevant for people with atrial flutter or other heart rhythm problems, especially those not taking blood thinners. It’s also important for anyone who eats raw fish regularly to be aware that severe abdominal pain after eating raw fish might have multiple possible causes. Healthcare providers should pay special attention to this case when evaluating patients with atypical presentations of common conditions.
In this case, the patient’s symptoms improved immediately after the blood clot was removed and blood flow was restored. However, recovery from the additional surgical procedure took longer. Most patients would expect to return to normal diet and activities within several weeks after such treatment, though individual recovery times vary.
Want to Apply This Research?
- If you have atrial flutter or irregular heartbeat, track instances of severe abdominal pain, noting the time of day, what you ate, and symptom severity on a scale of 1-10. Also log any episodes of heart palpitations or irregular heartbeat sensations that occur around the same time.
- Users with known atrial flutter should set daily reminders to take prescribed anticoagulation medications (blood thinners) as directed by their doctor. Users should also log their diet, particularly noting consumption of raw fish or other foods that might trigger gastrointestinal symptoms, to help identify patterns.
- Maintain a symptom diary that tracks abdominal pain episodes, heart rhythm irregularities, and medication adherence. Share this data with your healthcare provider at regular check-ups to help identify patterns and ensure your treatment plan is working effectively. Set up alerts for any severe or persistent abdominal pain to prompt immediate medical attention.
This case report describes a single patient’s experience and should not be used for self-diagnosis. Severe abdominal pain is a medical emergency requiring immediate professional evaluation. If you experience sudden severe stomach pain, call emergency services or go to the nearest emergency room immediately. This information is educational and does not replace professional medical advice. Anyone with atrial flutter or heart rhythm problems should work with their healthcare provider to develop an appropriate treatment plan, which may include blood thinners to prevent clots. Do not make changes to your medications or diet based on this case report without consulting your doctor.