Abstract

TIAGO, José; MINISTRO, Augusto; NUNES, José Silva  and  FERNANDES E FERNANDES, José. Acute intestinal ischemia: institutional experience of five years (2007-2012). Angiol Cir Vasc [online]. 2013, vol.9, n.1, pp.11-16. ISSN 1646-706X.

Acute mesenteric ischemia (AMI) continues to be associated with a high mortality rate over the last decades. The purpose of the present report is to assess a cohort of 14 patients with AMI undergoing emergent surgery due to either superior mesenteric artery (SMA) embolism or thrombosis. This study is an observational and retrospective analysis during a 5-year period (2007-12). The main objective was to analyze clinical and demographic characteristics, diagnostic and therapeutic approaches and factors that affected the AMI mortality rate. 14 patients, 8 were women (57%) and 6 were men (43%) with a mean age of 75 years. SMA embolism was the cause o AMI in 70% of cases. Cardiac arrhythmias and hypertension were the most common co-morbidities. Most cases were diagnosed after 24 hours of clinical evolution and abdominal pain was the predominant symptom. Leukocytosis, elevated blood level of lactate dehydrogenase and positive d-dimers were also the most common biochemical markers. Ten patients were submitted to embolectomy and four to SMA bypass. 50% underwent intestinal resection and a second look was carried out in 14%. 30-day mortality was 57% (60% in embolism and 50% in thrombosis). Advanced age, multiple co-morbidities and prolonged ischemia were contributing factors to this high mortality.

Keywords : Acute mesenteric ischemia; Surgical revascularization; Embolism/Thrombosis of the superior mesenteric artery.

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