Acute mesenteric ischemia

ABSTRACT

A retrospective study of 38 cases with mesenteric ischemia is presented. It included 12 cases [31.6%] with embolism, 9 cases 23.7% with arterial thrombosis, 3 cases [7.9%] with non occlusive infarction and 14 cases [36.8%] with venous occlusion. Preoperatively the main problem was delay in diagnosis as the classic clinical picture was present in only 52.6% of cases. The plan of treatment was to revascularize the intestine, whenever possible in mesenteric arterial occlusion by embolectomy or bypass graft and, to resect frankly gangrenous bowel with primary anatomosis. A second look was done after revascularization of long bowel segments especially when bowel of questionable viability was left behind and in selected cases of mesenteric venous occlusion. The overall mortality was 47.4%, highest in nonocclusive mesenteric ischemia and lowest in mesenteric venons occlusion