Let me detail you for a male patient aged 50 years with HIV/AIDS. He had CD4 count 1256./ml. He was very regular on HAART regimen which means his PLHA. He was seen by me for the last few days. C/o vague pain at abdomen which was moderately severe without any additional symptoms. His initial U/S abdomen showed only splenic infarct of 4 CMC.
He was not relieved by Tramadol, Butylscopolamine, Proton pump inhibitors and was submitted for CT scan abdomen. He was suggested for partial occlusion of superior mesenteric artery at its origin. Occlusion of splenic artery was found to be around 20% with rich collaterals. Under parenteral Heparin, s/o increased risk of thromboembolism in PLHAs. What can be the further management? Kindly suggest.
