Τίτλος:
Acute mesenteric ischaemia, a highly lethal disease with a devastating
outcome
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Acute mesenteric ischaemia remains a serious condition
requiring emergency surgical management. The mortality rate still
remains high, due to the unspecific and delayed diagnosis and ranges
from 59% to 100%. Purpose of our study is to present our experience in
the management of the disease.
Patients and methods: This is a retrospective study of 61 patients
treated surgically for acute mesenteric ischaemia, between 1988 and
2004. All patients underwent a laparotomy. 75% of the patients were
operated within the first 24 hours and the rest within 48 hours.
Results: Superior mesenteric artery embolism occurred in 36 (59%),
thrombosis in 21 (34%) and superior mesenteric vein thrombosis in 4
(7%) cases. In 49 (80%) cases, embolectomy or thrombectomy of the
superior mesenteric artery with resection of the necrotic segment of the
bowel was performed. Twelve cases (20%) were considered inoperable
because of massive bowel necrosis. According to our study mortality and
morbidity rate amounts to 75% and 80% respectively. No significant
difference in the mortality rate between patients with embolism (75%)
and thrombosis (76%) was found. However a significant increase of
mortality rate was observed when the surgical intervention became
afterwards the first 24-hour period. (72% versus 87%). Patients who
underwent embolectomy or thrombectomy with bowel resection presented an
improved survival rate compared with patients that underwent only bowel
resection. (p = 0.019).
Conclusions: Acute mesenteric ischaemia has the characteristics of a
highly lethal condition and only early recognition and appropriate
treatment can reduce the potential for a devastating outcome. The
reduction of time interval from the beginning of symptoms up to the
treatment remains the main critical important factor.
Συγγραφείς:
Safioleas, M. C.
Moulakakis, K. G.
Papavassiliou, V. G. and
Kontzoglou, K.
Kostakis, A.
Περιοδικό:
VASA-JOURNAL OF VASCULAR DISEASES
Εκδότης:
Verlag Hans Huber
Λέξεις-κλειδιά:
mesenteric ischemia/ischaemia; occlusive disease; superior mesentery
artery; angioplasty; acute
DOI:
10.1024/0301-1526.35.2.106
