ABSTRACT
INTRODUCTION:Acute mesenteric ischemia usually presents as abdominal pain that is out of proportion inrelation to tenderness; persistent vomiting, bloody diarrhea and shock. Sloughing of intestinal mucosa takes 3 hourswhile infarction of entire bowel thickness occurs in 6 hours. [1]- [3] CECT abdomen with mesenteric angiography isinvestigation of choice. If patient has presented after 24-48 hours, gangrene might have already occurred, resectionand anastomosis is done majority of cases with removal of vascular block under Doppler guidance or Injection ofpapaverine. Minimum bowel length required to be retained is 1.2 meters, otherwise the patient will have highmortality due to short bowel syndrome. [4]- [7]AIMS AND OBJECTIVES 1 ] To compare the surgical findings in various case scenarios having differentpresentations, patient factors and time of presentations with SMA thrombosis 2 ]To compare outcomes of surgicalintervention in different case scenariosCONCLUSION:SMA thrombosis was seen in non-covid time as well. Hypercoagulable state which corresponds toraised d-dimer and FDP, the cases of mesenteric ischemia due to SMA thrombosis are seen more commonly incovid-19 era. This series draws to attention that timely diagnosis and appropriate surgery with resection and properfollow up with anti-coagulant the morbidity and mortality is averted. Acute mesenteric ischemia is commonly due toemboli (45-50%) rather than thrombosis (20-25%). Non occlusive disease (5-15%) can be due to various causes e.g.,pancreatitis, sepsis, heart failure, etc. Early diagnosis is the key to successful management. Aggressive resuscitation,early revascularization with vascular intervention and exploratory laparotomy is done if evidence of peritonitis ispresent.[8]-[9] Postoperative fluid management due to short bowel syndrome and appropriate antibiotic coverage isnecessary to revive the patient. Long term TPN support for patients with short bowel patients is necessary. They arecandidates for intestinal transplantation if survived.[10]