Acute mesenteric ischemia

[DogHospiceMom]

In September I went to the ED with acute abdominal pain which continued to worsen for 20 hours. After several tests I was taken by ambulance to the hospital where I stayed having tests for 3 days. In the hospital stay one of the tests was an Abdominal Dupex Complete Study which showed a a high grade compression of the celiac trunk. Based on this another test was ordered, Ct Abdomen Pelvis Angiography with IV Contrast. That showed there appears to be no appreciable flow of any contrast in the left femoral or iliac veins contrasted venous flow occurs partially with observed thrombus in the right common and external iliac vein on the right no contrast is seen to enter the IVC from the left side of the pelvis. The IVC appears to be decompressed along with possible portal vein thrombosis. Further workup with ultrasound in this area is recommended. The doctor who order this didn’t read it for 2 weeks and then ordered a STAT CAT Scan with contrast of Lungs because she said I had multiple blood clots in liver, Vena Cava and more. The CAT was clear for clots in lungs but showed compression and Atelectasis. I was sent to a Vascular Surgeon who said there was nothing wrong. However when he spoke with the doctor who ordered this, he back peddled and said the timings were off. They then wanted to immediately put me on blood thinners before having 2 more tests US Abdomen Duplex Complete and US Liver with Doppler. The medication Xeralto was $557. On GoodRx. I can’t afford the prescriptions I’m on now so I refused. I go tomorrow for those 2 tests and have a 2nd opinion scheduled with another Vascular Surgeon. Any advice?

[zoe69 Moderator Volunteer Vasculitis UK]

What a difficult situation to be in.

I live in the UK so the healthcare system is different. I hope the scans will give a clear icon of what's going on and a more affordable solution will be found.

[oldtimer2]

This is an impossible situation for you as you really need to be on an anticoagulant if you have really have that many clots. But is there some doubt about the interpretation - the vascular surgeon sounds in some doubt. Perhaps the second opinion will make things a bit clearer for you. Best of luck!

[DogHospiceMom in reply to oldtimer2]

I just came back from the hematologist appointment and based on the further testing does not believe I need blood thinners. When I asked about Vasculitis she said that it would make sense because the Vasculitis would show up as a bubble in the vein that may have been misinterpreted as a clot. The clots that showed up initially were so large she said it would have taken months to disappear and the fact that 3 weeks later they were not seen at all is bizarre. She is reaching out to the radiologist who read both reports to see if it was vascular bubbles. However, she does want me to keep my appointment next week with another vascular surgeon for a second opinion.

[oldtimer2]

That sounds interesting and certainly clots wouldn't disappear that quickly, so her explanantion sounds more likely.

I've had previous problems with radiological interpretation because of assumptions being made on the basis on common things occur commonly, but 'us lot' are 'uncommon'!