[Lysis therapy of thrombosis of the superior mesenteric artery].
BACKGROUND
For surgeons the acute intestinal ischaemia is still a diagnostic and therapeutic challenge. If clinically suspected, the diagnostic procedures such as duplex sonography and arterial angiography should be carried out immediately. Although the diagnosis is often quickly clear, perioperative mortality rate remains high. We report the acute local thrombolytic therapy as an alternative treatment.


METHODS
A 80-year-old male patient was referred to our hospital with a complete occlusion of the superior mesenteric artery. Duplex sonography and the arterial angiogram confirmed the clinical diagnosis. Because the patient was assessed to be at high risk we decided to avoid an operation and local thrombolytic therapy using rt-PA and urokinase was carried out.


RESULTS
The local thrombolytic therapy was successful and led to a complete restoration of the arterial flow within the superior mesenteric artery. The clinical symptoms subsided and no complications were observed.


CONCLUSIONS
Local thrombolytic therapy appears to be a suitable therapeutic option in patients suffering of mesenteric arterial occlusion. Although the duplex sonography often confirms the diagnosis with high accuracy the angiography remains the diagnostic gold standard.
Hommann
M
M
Klinik für Allgemeine und Viszerale Chirurgie, Friedrich-Schiller-Universität Jena.
Richter
K K
KK
Heyne
J
J
Behrend
U
U
Rimpler
H
H
Will
U
U
Bartel
M
M
Scheele
J
J
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D006801:Humans; D007422:Intestines / Q000098:blood supply; D007511:Ischemia / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D017538:Mesenteric Artery, Superior; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000175:diagnosis / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator