Early diagnosis and surgical treatment of acute superior mesenteric artery occlusion

摘要

Background/Aims: To investigate the value of early diagnosis and the effect of surgical treatment of acute superior mesenteric artery occlusion. Methodology: Forty-eight patients underwent superior mesenteric artery embolectomy. The diagnosis was made by mesenteric angiography in 12 patients, by explorative laparotomy in 15 patients and by abdominal contrastenhanced CT in 21 patients. The patients were divided into three groups according to the onset of symptoms and operation time. Patients in group I (n = 15) were operated on in the first 6 hours after onset of symptoms; Patients in group II (n = 19) were operated on between 6 and 12 hours after onset; and patients in group III (n = 14) underwent embolectomy after 12 hours. Results: The macroscopic view of the intestine was normal in 24 patients (15 in group I and 9 in group II) 30 minutes after embolectomy and administration of urokinase. Segmental resection was necessary in 8 patients in group II. Extended resection was necessary in 2 patients in group II and 14 patients in group III, and all of the patients died during the early postoperative period. Conclusions: Early diagnosis and prompt surgical treatment can reduce the incident of bowel necrosis and mortality rate of patients with superior mesenteric artery occlusion.