Affiliation:
1. Department of Surgery, University Hospital, CH-4031 Basle, Switzerland
Abstract
Abstract
Eighty-one cases of mesenteric infarction documented by angiography, laparotomy or autopsy were reviewed to assess the cause of the persistently high mortality. Thirty-seven patients (46 per cent) were felt to have inoperable lesions and were treated by supportive care only, while forty-four (54 per cent) underwent bowel resection and/or revascularization. Of these 44 patients 20 (45 per cent) survived, 14 (32 per cent) died of an early recurrence of infarction and 10 (23 per cent) died of an unrelated cause. In view of the high recurrence rate in the early postoperative period, treatment must prevent the causes of persistent or recurrent ischaemia such as vasoconstriction and reperfusion tissue damage. On the basis of recent clinical and experimental research we suggest that treatment should include routine angiography with selective perfusion of vasodilators through the superior mesenteric artery, pharmacological prevention of ischaemic and reperfusion tissue damage before surgery, and postoperative anticoagulation.
Publisher
Oxford University Press (OUP)
Reference45 articles.
1. A study of 136 patients with mesenteric infarction;Ottinger;Surg Gynecol Obstet,1967
2. Mesenteric ischemia;Ottinger;N Engl J Med,1982
3. Causes of death in mesenteric arterial occlusion: 2 observations on revascularization of the ischemic bowel;Marston;Ann Surg,1963
4. Intestinal ischemic shock in germ-free animals;Carter;Surg Gynecol Obstet,1966
5. Myocardial effect of mesenteric ischemia;Williams;J Surg Res,1969
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