Initial results from an aggressive roentgenological and surgical approach to acute mesenteric ischemia

Scott J. Boley, Seymour Sprayregan, Stanley S. Siegelman, Frank J. Veith

Research output: Contribution to journalArticle

222 Scopus citations

Abstract

The 70% to 80% mortality rate of patients with acute mesenteric ischemia (AMI) has remained unchanged over the past 40 years. We report here the initial results using an aggressive approach to this problem. This included the earlier and more liberal use of angiography in patients at risk and the intra-arterial infusion of papaverine for the relief of superior mesenteric artery (SMA) vasoconstriction in both nonocclusive and occlusive forms of AMI. Of the first 50 patients managed by this approach, 35 (70%) had AMI demonstrated by SMA angiography. Nineteen (54%) of these 35 patients survived, including nine of 15 patients with nonocclusive mesenteric ischemia, seven of 16 with SMA embolus, two of three patients with SMA thrombosis, and the one patient with mesenteric venous thrombosis. Seventeen of the 19 survivors lost no bowel or had excision of less than 3 feet of small intestine.

Original languageEnglish (US)
Pages (from-to)848-855
Number of pages8
JournalSurgery
Volume82
Issue number6
StatePublished - Dec 1977

ASJC Scopus subject areas

  • Surgery

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