Analysis of 24 cases of small intestinal obstruction secondary to mesenteric ischemia
10.3760/cma.j.cn115455-20250301-00189
- VernacularTitle:肠系膜缺血继发小肠梗阻24例分析
- Author:
Wan ZHONG
1
;
Xiang ZHAO
1
;
Hai GAO
1
;
Jinsheng XU
1
;
Jian WANG
1
Author Information
1. 南京医科大学第四附属医院普通外科，南京 210031
- Publication Type:Journal Article
- Keywords:
Mesenteric ischemia;
Intestinal obstruction;
Necrosis;
Retrospective studies
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(9):783-787
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics and treatment methods of patients with small bowel obstruction secondary to mesenteric ischemia (MI).Methods:The clinical data of 24 patients with small intestinal obstruction secondary to MI from December 2021 to December 2024 in the Fourth Affiliated Hospital of Nanjing Medical University were retrospectively analyzed, including the clinical characteristics and surgical treatment.Results:Among the 24 patients with small intestinal obstruction secondary to MI, 19 were male and 5 were female, with ages ranging from 21 to 65 years old, and the disease course was 0.5 (1.0, 5.5) months. There were 8 cases of deep vein thrombosis, 6 cases of hypertension, 6 cases of atrial fibrillation, 5 cases of short bowel syndrome, 4 cases of abdominal trauma and 23 cases with a history of abdominal surgery. There were 4 cases of acute onset, presenting with full abdominal pain, elevated D-dimer and hematogenous intestinal obstruction. There were 20 cases of chronic onset, presenting with recurrent abdominal pain, weight loss and mechanical intestinal obstruction. The pathogenic factors were superior mesenteric vein thrombosis in 7 cases, superior mesenteric arteriosclerosis in 6 cases, mesenteric injury repair in 4 cases, superior mesenteric artery embolism in 3 cases, superior mesenteric aneurysm in 2 cases, superior mesenteric artery dissection in 1 case, and ileocolic aneurysm in 1 case. Three patients underwent surgical operations after the failure of interventional surgeries, and 20 patients were directly treated with surgery. The small intestinal obstruction was completely relieved in all cases. Another case was treated conservatively, but the small intestinal obstruction was not completely relieved.Conclusions:Small bowel obstruction secondary to MI is often atypical. CT angiography should be performed to identify the cause of obstruction due to deep vein thrombosis, atrial fibrillation, abdominal trauma or abdominal surgery. Surgery is the preferred treatment.
