[Acute mesenteric artery occlusion--clinical aspects, therapy, prognosis]

Abstract

During the last 10 years 52 patients with acute mesenteric artery occlusion underwent surgery. There were 19 males and 33 females with a mean age of 73.0 years. 33 patients (63.5%) died postoperatively within 30 days. In 12 cases laparotomy demonstrated inoperability. Resections of the necrotic small intestine were performed in 21 cases, in 6 cases also of the colon. Resections of the intestine were combined in 16 cases with vascular procedures (embolectomy or thrombendarterectomy of the mesenteric superior artery or implantation of aorto-mesenterial or iliaco-mesenterial bypass). In 5 patients a second look - operation was performed with 2 survivors. In 3 cases the clinical diagnosis of mesenteric artery occlusion was proven by preoperative angiography. The prognosis of acute intestinal ischemia can only be improved by early diagnosis and operative treatment. Surgery is aimed at removing the necrotic tissue and restoring an adequate blood flow to the remaining bowel.