A Clinical Review of Acute Mesenteric Ischemia
Journal of the Korean Society for Vascular Surgery
;
: 163-167, 2007.
Article
Dans Coréen
| WPRIM
| ID: wpr-150431
ABSTRACT
PURPOSE:
Acute mesenteric ischemia (AMI) is difficult to diagnose and has a high rate of complications as well as a high mortality rate. The aim of this study was to define the risk factors and mortality rate of patients with acute mesenteric ischemia.METHOD:
We retrospectively reviewed 18 patients with acute mesenteric ischemia at the Kangbuk Samsung Hospital from June 1995 to May 2006.RESULT:
The mean age was 51.1 (age range, 27 to 78 years) and the gender ratio was 21 (male, 18, female, 6). The most common underlying diseases were hypertension (50%, n=9), diabetes mellitus (44.4%, n=8), artrial fibrillation (22%, n=4), and congestive heart failure (11%, n=2). Abdominal pain was the most frequent presenting symptom; other symptoms included nausea, vomiting and hematochezia. To confirm the diagnosis, a CT was performed in 10 cases, a CT and angiography was performed in four cases, and exploratory surgery in four cases. The causes of the acute mesenteric ischemia were SMA embolism in eight cases (44%), SMA thrombosis in 5 cases (27%), SMA with IMA thrombosis in 1 case (5%), IMA thrombosis in 1 case (5%), SMV thrombosis in 2 cases (11%), and SMV with IMV thrombosis in 1 case (5%). All of the patients underwent abdominal exploration, 16 cases had bowel resection performed, one case had a thromboembolectomy performed, and one case was opened and closed. Complications occurred in nine (50%) patients. Sepsis in three, wound infection in three, short bowel syndrome, toxic hepatitis, pulmonary embolism, and ischemic heart disease also occurred. The overall mortality rate was 33.3% (6 cases). The mortality rate with a SMA embolism was 5% (1 case), with SMA thrombosis was 40% (2 cases), with SMA+IMA thrombosis was 100% (1 case), in IMA thrombosis 100% (1 case), in SMV thrombosis was 0%, and 100% in SMV+IMV thrombosis.CONCLUSION:
Despite the low incidence of acute mesenteric ischemia, it is still a life-threatening condition. Thus, when mesenteric ischemia is suspected, early diagnosis, with CT or angiography is required, and thrombolytics and surgery should be considered to improve the prognosis.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Pronostic
/
Embolie pulmonaire
/
Syndrome de l'intestin court
/
Thrombose
/
Vomissement
/
Infection de plaie
/
Angiographie
/
Douleur abdominale
/
Incidence
/
Études rétrospectives
Type d'étude:
Etude diagnostique
/
Etude d'étiologie
/
Etude d'incidence
/
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
/
Étude de dépistage
Limites du sujet:
Femelle
/
Humains
langue:
Coréen
Texte intégral:
Journal of the Korean Society for Vascular Surgery
Année:
2007
Type:
Article
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