A CLINICAL STUDY OF ACUTE SUPERIOR MESENTERIC ARTERY OCCLUSION

概要

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We experienced five cases of acute superior mesenteric artery occlusion (SMAO) over the past four years, and conducted a clinical assessment of the diagnosis, treatment and prognosis of SMAO. A case suggestive of SMAO with the symptom of abdominal angina for one year before is also presented. The mean age of the five patients was 72 years, and their chief complaint was abdominal pain of acute onset. Three patients had a past history of arterial fibrillation, and one case was associated with rupture of an abdominal aortic aneurysm. The preoperative diagnosis was peritonitis or ileus, and angiography was not performed. At surgery, a partial resection of the small bowel was carried out in two cases and wide resection of the small bowel plus right hemicolectomy in two cases. Another case was unresectable because of very poor general condition. Only two patients underwent surgery within 24 hours after the onset. Angiography should be performed on suspicion of SMAO when old patients with heart disease suddenly develop abdominal pain. Early diagnosis and emergency treatment are considered important to improving the prognosis.
北関東医学会の論文