Severe abdominal complaints after technical successful endovascular treatment of chronic splanchnic ischemia

Reperfusion syndrome (RS) after revascularization of an arterial occlusion of the lower leg is a well-known complication. RS after splanchnic revascularization however, is an infrequent and less known phenomenon. We present a patient with persisting abdominal complaints after revascularization of the celiac trunk and superior mesenteric artery suggesting reocclusion. CT angiography showed patent splanchnic arteries but a striking hyperperfusion state of liver and spleen. Complaints diminished steadily with conservative therapy but RS can cause severe complications such as liver failure and multiple organ failure. Ignorance of RS might interfere with adequate treatment and can contribute to a high in-hospital mortality rate.