Clinical Review of Acute Mesenteric Ischemia.
- Author:
Jong Do JEONG
1
;
Jun Ho LEE
;
Sun Jung LEE
;
Seong Yul RYU
;
Seong Youn HWANG
Author Information
1. Department of Surgery, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Korea. sunjung2@samsung.co.kr
- Publication Type:Original Article
- Keywords:
Mesenteric vascular occlusion;
Embolism;
Thrombosis
- MeSH:
Abdominal Pain;
Angiography;
Atrial Fibrillation;
Critical Care;
Delayed Diagnosis;
Diagnosis;
Early Diagnosis;
Embolism;
Female;
Humans;
Hypertension;
Ischemia*;
Male;
Medical Records;
Melena;
Mesenteric Vascular Occlusion;
Mortality;
Myocardial Infarction;
Retrospective Studies;
Surgical Procedures, Operative;
Thrombosis;
Tomography, X-Ray Computed;
Vomiting
- From:Journal of the Korean Society for Vascular Surgery
2004;20(1):78-82
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The purpose of this study was to review our clinical experiences of acute mesenteric ischemic disease at the Masan Samsung hospital. METHOD: Retrospectively reviewed the medical records of 20 patients with acute mesenteric ischemic disease from 1998 through 2003 in terms of clinical characteristics, image findings, management and results. RESULT: The mean age of patients was 63.5 years and the male female ratio was 1.5:1. Coexisting diseases were atrial fibrillation (n=10), hypertension (n=9), myocardial infarction (n=2), DM (n=4). The clinical manifestations were abdominal pain, abdominal distension, peritoneal irritation signs, vomiting and melena. The presenting signs were nonspecific. Laboratory findings were nonspecific and not helpful for diagnosis of acute mesenteric ischemia. Abdominal CT and SMA angiography were accurate and sensitive diagnostic tools. Seventeen cases were SMA occlusion (1 case: SMA dissection) and 3 cases were SMV occlusion. Operative procedures were resection of bowel (12 cases) and thromboembolectomy (5 cases). Non operative procedure was anticoagulation (3 cases). One patient refused surgery. CONCLUSION: Both clinical and laboratory data were non-specific and delayed diagnosis was the main cause of the overall mortality rate of 35% (7 cases). The mortality rate for patients undergoing surgery for acute mesenteric ischemic disease was high, but early diagnosis and intensive care may be reduced mortality.
