[Mesenteric ischemia--late diagnosis or managed disease?].
OBJECTIVE
Diagnosis and therapy of mesenteric ischaemia as the cause of an acute abdomen is a serious problem because of its 60-80% mortality. The study presents experience with diagnosis and therapy of this disease and it compares its results with those in the literature.


RESULTS
Throughout the years 2000-2009, there were 39 patients surgically treated with mesenteric ischaemia (17 men, 21 women, the average age 73 I 9.43). 38.46% of patients underwent resection of small and large bowel, in 33.3% only a part of small intestinum was resected, and in two cases (5.13%), the resection was combined with the embolectomy of artery mesenteric superior. In 23.1% of patients, only an explorative laparatomy was performed, because of an extended affection. Four patients were reoperated (dehiscence of anastomosis, perforation of small bowel, dehiscence of the wound, enterocutaneous fistula). 23% of patients needed ventilation because of postoperative complications such as respiratory insufficiency, sepsis and heart failure. There was 53.8% mortality. The abdominal pain (79%), vomitus (61.5%) and subileus (35.9%) predominated in the clinical picture. Leucocyts were elevated in 58.97% of patients. X ray examination showed non specific findings, and ultrasonography has proven to be successful in 42.3% of cases.


CONCLUSIONS
Mortality of patients is significantly increased by low success rate of the depictive methods, non-specific clinical picture, co-morbidity in elderly patients and by late arrival to hospital.
Radonak
J
J
I. Chirurgická klinika, Lekárska fakulta Univerzity Pavla Jozefa Safárika, Kosice, Fakultná nemocnica L. Pasteura, Kosice, Slovenská republika. radonak@gmail.com
Lakyová
L
L
Toporcer
T
T
Bober
J
J
D000208:Acute Disease; D000368:Aged; D005260:Female; D006801:Humans; D007422:Intestines / Q000098:blood supply; D007511:Ischemia / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis; D008643:Mesentery / Q000098:blood supply*