The danger of misdiagnosis of mesenteric ischemia

 

Delaying diagnosis and treatment can lead to dead or necrotic stomach or bowel, and even death

 
February 27, 2018

As a Houston, Texas medical malpractice lawyer, I have represented quite a number of clients who have suffered terrible life-changing injuries as a result of misdiagnosed, untreated ischemic stomach or bowel.

Mesenteric ischemia

Ischemia is a medical word that means that blood flow has been cut off to a particular area of the body.

Mesenteric ischemia is a type of peripheral artery disease, specifically meaning that there is poor circulation in the blood vessels supplying the stomach, liver, colon, and intestines.

Some patients experience mesenteric ischemia suddenly, typically having severe stomach pain, sometimes accompanied by nausea and vomiting. Other patients develop mesenteric ischemia over time. The telltale sign of this chronic illness is severe stomach pain within an hour after eating any meal.

According to vascular surgery experts, the sudden, or acute, type of mesenteric ischemia is usually caused by a blood clot that  blocks blood flow. The type that develops over time, also called chronic mesenteric ischemia, is often caused by plaque or atherosclerosis, which slows down flow through blood vessels.

When patients contact me to review their potential medical malpractice case, they often describe the damage from mesenteric ischemia as a dead or necrotic stomach or bowel. This can be a life-changing situation, in that necrotic portions of these vital organs have to be surgically removed.

Misdiagnosis

The danger of misdiagnosing mesenteric ischemia is that the longer the blood supply is reduced or cut off to an area of the body, the more expansive the damage, including death, to vital organs.

An example of a 49-year-old lady illustrates the danger to patient safety when doctors, and even specialists, misdiagnose mesenteric ischemia. This patient went to see her primary care physician because of problems with abdominal pain after eating, which doctors describe as post-prandial pain. Her abdominal pain was occasionally associated with vomiting and diarrhea.

The primary care provider referred her to a gastroenterologist, who ordered an upper G.I. radiology study, as well as an upper G.I. endoscopy and colonoscopy. Unfortunately, all of the studies were misinterpreted and this lady’s pain continued, unrelieved even by powerful opioid painkillers. Sometimes the pain was so severe that she writhed in agony on the floor.

Over the course of three months, she went to an emergency room complaining of severe abdominal pain and weight loss. She had lost an astounding 35% of her body weight over the same time span, and weighed-in at just 65 pounds.

A second gastroenterologist who was covering for her primary physician correctly diagnosed bowel ischemia on three different occasions, but her normal treaters, including the first gastroenterologist, primary care doctor, and then endocrinologist disagreed. On her final visit to the hospital, the new gastroenterologist ordered a mesenteric angiogram, which confirmed his original diagnosis of ischemic bowel.

By then, though, her entire bowel was dead. She underwent several surgeries aimed at patching together her gastrointestinal (GI) tract, but tragically passed away around three months later.

Sadly, this middle-aged mother died because her physicians overlooked her textbook symptoms of mesenteric ischemia of the bowel—severe abdominal pain after eating, vomiting, diarrhea, and weight loss. In addition, even when a substitute gastroenterologist made the right call, no one followed through to order testing that would have allowed the correct diagnosis and prompt surgical attention that would have saved her bowel and life.

What you can do

If you have any of the symptoms of mesenteric ischemia, I think it is a good idea to get seen and evaluated by a vascular surgeon. Based on your history and symptoms, the vascular surgeon may order tests, including a CT angiogram (CTA), angiogram, or Doppler ultrasound, all of which aid in arriving at the right diagnosis.

Once the diagnosis of mesenteric ischemia is diagnosed, the vascular surgeon turns attention to treatment, which is sometimes emergency surgery.

We are here to help

If you or a loved one has been seriously injured as a result of medical malpractice, call the experienced attorneys at Painter Law Firm, in Houston, Texas, at 281-580-8800, for free consultation about your potential case.

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Robert Painter is an attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, doctors, surgeons, pharmacists, and other healthcare providers. In 2017, H Texas magazine listed him among Houston’s top lawyers. The same year, the Better Business Bureau honored Painter Law Firm with its Award of Distinction.

Robert Painter

Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.

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