Studies on 7 Cases of Acute Mesenteric Arterial Occlusive Disease

Naoto Kawakita, Tomoaki Urakawa, Mitsuharu Nakamoto, Toshimasa Yamaguchi, Hiroaki Tanaka, Atsunori Iso, Yukio Nishio, Kiyoshi Uematsu, Kazuhiko Iwakoshi

Department of Surgery, Kobe Rosai Hospital

We have had seven cases of acute mesenteric arterial occlusive disease at our department and have evaluated the clinical features and the prognostic factors of this disease. The mean age was 68.3 years and all the cases were complicated with cardiovascular and other disorders. Acidosis was observed in five cases (71.4%) and leukocytosis in four cases (57.1%). All the patients underwent massive resection of small intestine. Four of these (57.1%) died shortly thereafter. The mean age at death was 75.8 years. It was 78 hours on an average between the onset of the disease and the surgery. This interval tended to be longer than it was in survivors, namely 16 hours. Whereas 75.0% of the patients with leukocytosis count died, only 33.3% of the cases with normal leukocyte count. Of the four dead patients, three died as a result of incomplete suture or perforated gastrointestinal tract, probably associated with pre-operative impaired blood circulation. To improve the prognosis of acute mesenteric arterial occlusive disease, it is important to agressively resect the intestinal tract to avoid postoperative necrosis. Furthermore, it seems essential prior to such surgical procedure, to diagnose this disease early by using angiography and so forth.

Key words
acute mesenteric arterial occlusive disease, massive resection of small intestine, the prognosis of acute mesenteric arterial occlusive disease

Reprint requests
Naoto Kawakita Department of Surgery, Kobe Rosai Hospital
4-1-23 Kagoikedori, Chuo-ku, Kobe, 651 JAPAN

Accepted
December 13, 1989

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