Chronic Intestinal Ischemia Research Articles

Treatment of chronic visceral ischemia

Herein, we have described the surgical management of 23 patients with chronic intestinal ischemia. The patients presented most commonly with postprandial pain and weight loss. Diagnosis was confirmed by angiography, including lateral aortography. Surgery included bypass with Dacron being the most common graft material. As many vessels as possible were revascularized using an infrarenal graft origin. Two patients died postoperatively from acute myocardial infarction. There were two graft failures in this group. At the present time, 19 of the 21 surviving patients are asymptomatic or greatly improved.

Chronic visceral ischemia. An often overlooked cause of abdominal pain.

Chronic intestinal ischemia is usually caused by atherosclerosis of the visceral branches of the abdominal aorta. It classically presents with severe postprandial abdominal pain, weight loss due to fear of eating, and altered intestinal motility. Aortography is the definitive diagnostic study and usually reveals occlusive disease of at least two major visceral vessels. Revascularization is indicated in symptomatic patients but should be undertaken in asymptomatic patients only when aortic reconstruction is indicated that would threaten intestinal collateral blood flow. Refinements in operative technique and perioperative management have improved the safety and effectiveness of visceral reconstruction procedures.

Diastolic bruit in chronic intestinal ischemia

Application of abdominal phonoanogiography in patients with suspected chronic intestinal ischemia may be diagnostic or highly suggestive of vascular compromise. The importance of a diastolic abdominal bruit is illustrated in two patients with intestinal ischemia.

Mesenteric revascularization: An operative approach

Chronic intestinal ischemia was successfully treated with isolated superior mesenteric revascularization despite the involvement of multiple visceral arteries. An operative approach was used in which both the aorta and the superior mesenteric artery were exposed in the area between the inferior border of the pancreas and the superior border of the fourth portion of the duodenum. This approach is applicable in thin patients and allows a short, horizontal graft that appears to increase long-term patency.