ABSTRACT
Although the classic therapy for chronic mesenteric ischemia is surgical revascularization, endovascular therapy is a new therapeutic option. We report a 55 year-old female, with a 2 years history of post prandial abdominal pain, diarrhoea, and weight loss, with occlusion of both mesenteric arteries and critical stenosis of the celiac artery. The initial treatment consisted in angioplasty and celiac artery stent placement in two occasions, with a brief symptomatic relief. Finally, a visceral artery bypass was performed, with good post operative outcome and complete symptomatic resolution at one year follow up. In our opinion endovascular therapy is a good therapeutic option for chronic mesenteric ischemia in high surgical risk patients, specially when dealing with stenotic injuries. It may also be a complement for patients who need to recover their nutritional status prior to revascularization surgery. On the other hand, due to the long term patency and symptomatic relief, surgical treatment is a good option in low risk patients.
Subject(s)
Female , Humans , Middle Aged , Celiac Artery/surgery , Ischemia/surgery , Mesenteric Artery, Superior/surgery , Mesenteric Vascular Occlusion/surgery , Angioplasty, Balloon , Celiac Artery , Celiac Artery , Chronic Disease , Constriction, Pathologic , Constriction, Pathologic/surgery , Mesenteric Artery, Superior , Mesenteric Artery, Superior , Recurrence , Treatment Outcome , Ultrasonography, Doppler, DuplexABSTRACT
Una encuesta efectuada a cuarenta cirujanos de servicios de urgencia dió como resultado que un 75 por ciento priorizaba la tomografía computada como examen para el diagnóstico de obstrucción intestinal. Esto nos motivó a revisar los hallazgos manifestados en ésta, en diferentes patologías que determinan obstrucción intestinal, tomando ejemplos de nuestro archivo de casos. Analizamos además, en orden de importancia las respuestas que los cirujanos esperan de este examen, de acuerdo a los resultados de esta encuesta.