History of mesenteric ischemia. The evolution of a diagnosis and management

Abstract

This article has traced the evolution of our knowledge of mesenteric ischemia from the initial stage of recognition of the condition and its manifestations, through the phase of treatment after the fact-resection of gangrenous intestine, to our present-day attempts to diagnose and treat the ischemic episode before death of the bowel and patient occurs. It is history from the authors' perspective, and because of limitations of space it is, perforce, highly selective. Hundreds of valuable contributions could not be included, and their omission in no way detracts from their importance. A number of surgeons, including Williams and Bergen in this country, Marston in England, Saegesser in Switzerland, and Kieny in France, have made mesenteric ischemia a major focus of their careers and have published extensively on it. The first book devoted to all aspects of mesenteric ischemia, Vascular Disorders of the Intestines edited by Boley, Schwartz, and Williams, was published in 1971. Since that time a number of books and monographs have chronicled progress in the field. Together these references make a good foundation for newly interested investigators in the subject. The results of diagnosis and management of mesenteric ischemia have improved significantly over the past 100 years but remain poor. The best part of the history of mesenteric ischemia remains to be written.