Analysis of misdiagnosis and treatment of acute superior mesenteric arterial embolism
- VernacularTitle:急性肠系膜上动脉栓塞误诊及治疗分析
- Author:
Gang LI
;
Guang YANG
;
Gang CUI
;
Guancheng YIN
;
Jun LIU
- Publication Type:Journal Article
- Keywords:
Mesenteric Artery,Superior;
Arteroembolism/diag;
Acute Abdomen;
Diagnostic Errors
- From:
Chinese Journal of General Surgery
1997;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the early diagnosis and treatment of acute superior mesenteric arterial embolism (ASMAE).Methods The clinical data of 25 patients with acute superior mesenteric arterial embolism were retrospectively analyed.Results All 25(100%) patients had severe abdominal pain with abdominal signs,21(84%) patients had history of valvular heart disease or atrial fibrillation,and 17(68%) patients had hematochezia.All the cases were misdiagnosed preoperatively,including 11 patients were misdiagnosed as abdominal pain of unknown causes,3 patients as acute pancreatitis,3 patients as acute gastroenteritis,2 patients as necrotizing enteritis.1 patient as acute appenditis,1 patient as acute myocardial infarction,and 1 patient as acute cholecystitis;but 3 patients were preoperatively suspected to have impairment of mesenteric blood flow.All of the 25 patients underwent necrotic bowel resection,6 patients died,and 7 patients abandoned treatment because of serious complications such as short bowel syndrome etc.Mortality rate was 51%(13/25).Conclusions Early diagnosis of patients with acute superior mesenteric arterial embolism is difficult;the main cause of misdiagnosis is lack of recognition of its clinical signs.Fully grasping the characteristics of patients with early stage disease and effective early intervention are the fundamental measures for reducing mortality.
