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Editor's quiz: GI snapshot
Abdominal pain following percutaneous mitral valve repair (MitraClip)
  1. Albrecht Neesse1,
  2. Wilhelm Nimphius2,
  3. Michael Schoppet3,
  4. Thomas M Gress4
  1. 1Department of Gastroenterology II, University Medicine Goettingen, Goettingen, Germany
  2. 2Department of Pathology, University Hospital Giessen und Marburg GmbH, Standort Marburg, Marburg, Germany
  3. 3Department of Cardiology, University Hospital Giessen und Marburg GmbH, Standort Marburg, Marburg, Germany
  4. 4Department of Gastroenterology, Endocrinology, Infectiology and Metabolism, University Hospital Giessen und Marburg GmbH, Standort Marburg, Marburg, Germany
  1. Correspondence to Professor Dr Thomas Gress, Department Gastroenterology, Endocrinology, Infectiology and Metabolism, Philipps University Marburg, Baldingerstr., Marburg 35043, Germany; gress{at}med.uni-marburg.de

https://doi.org/10.1136/gutjnl-2014-308495

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    Clinical presentation

    An 81-year-old man underwent percutaneous mitral valve repair (MitraClip) due to severe symptomatic mitral valve regurgitation. Coronary heart disease was excluded prior to mitral valve repair. Approximately 8 h after the uneventful and successful intervention, the patient presented with progressive abdominal pain, in particular tenderness in the right upper quadrant with guarding. Laboratory tests did not reveal any acute alterations; serum lactate was 2.4 mmol/L. Bedside ultrasonography showed a distended ascending colon with a pronounced hyperechoic large bowel wall (figure 1A). Native CT imaging was performed (figure 1B). The patient subsequently underwent emergency laparotomy.

    Figure 1

    (A) Bedside ultrasonography …

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    Footnotes

    • Contributors AN: compilation of the case and figures, writing of the manuscript. WN, MS and TMG: compilation of the case and figures, critical revision of the manuscript for important intellectual content.

    • Competing interests None.

    • Provenance and peer review Not commissioned; internally peer reviewed.