Emergency revascularization of the superior mesenteric artery in acute intestinal ischemia caused by thrombosis.
Acute mesenterial ischemia resulting from thrombosis of atherosclerotic mesenterial arteries still carries a very high mortality, even when revascularization is undertaken early. Four patients are presented in whom acute revascularization of the superior mesenteric artery with minor intestinal resections were performed. Three of the patients had previous histories of abdominal angina; one of these died postoperatively. Of the surviving three patients, two were free of gastrointestinal symptoms 13 and 19 months after the operation respectively, while the last was still hospitalized three months postoperatively with frequent bouts of diarrhea and feeding problems. Since approximately 50 per cent of patients with acute intestinal ischemia develop abdominal angina prior to the acute exacerbation, it is of utmost importance to diagnose this condition before onset of the acute episode, as an elective operation has a low mortality and a good long-term prognosis. A dramatic improvement in the operative results of the acute episode are not to be expected, but revascularization as soon as possible after the onset of the acute episode combined with localized intestinal resection as required can improve the prognosis, especially in younger patients free from complicating cardiac disease.
D000368:Aged; D004380:Duodenal Obstruction / Q000601:surgery*; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011859:Radiography; D013478:Superior Mesenteric Artery Syndrome / Q000601:surgery*