A Clinical Review of Acute Superior Mesenteric Ischemic Disease

Jeon, Jae Yeong; Jung, Suk In; Kim, Nam Ryeol; Lee, Jae Bok; Choi, Sang Yong; Suh, Sung Ock; Whang, Cheung Wung

Abstract

PURPOSE: The prevalence and incidence of the superior mesenteric ischemic diseases are increasing nowadays because of the increase of aged people and cardiovascular diseases. The morbidity and mortality of the superior mesenteric ischemic diseases are so high and detrimental because acute mesenteric infarction results post operatively reperfusion injury short bowel syndrome and sepsis. A successful management requires very efficient diagnostic and therapeutic measures. So, we reviewed the medical records of superior mesenteric ischemic diseases and identified the clinical and therapeutic characters of these disease. METHOD: Between January 1991 and December 2000, 33 patients with a clinical diagnosis of superior mesenteric ischemic diseases supported by clinical and imaging studies were included in this study. The medical records of the 33 patients who had admitted Korea University Hospital were reviewed retrospectively and identified the clinical characters, the diagnostic tools, underlying diseases and the therapeutic modalities. RESULT: The most common cause of theses disease was the superior mesenteric arterial embolism and the peak incidence was identified in 7th and 8th decades. These diseases were diagnosed with physical examination, abdominal CT or angiogram, but almost half of them were identified at the operative field. 29 patients were treated surgically and the rest of them were medically. At result 12 patients died of these diseases (36.4%). The high WBC count (15,000/ml) and shock were considered as prognostic factors predicting for the mortality (p=0.005).
CONCLUSION
The old persons who were suffered from the nonspecific abdominal pain should be suspected of these diseases and treated with properly applied diagnostic tools and therapeutic modalities, especially they show the leukocytosis and the clinical evidence of shock.