Bypass Surgery, Using Prosthetic Graft, and Bowel Resection, Simultaneously Performed for Chronic Superior Mesenteric Artery Occlusion

Kota Yamamoto, Tomohiro Takenoue and Hiroshi Shinkai

Department of Surgery, Chigasaki Municipal Hospital

A 77-year-old man undergoing two operations within one month for ileal and colon necrosis due to ischemia was found in postoperative angiography to have intestinal blood flow from the inferior mesenteric artery alone. While waiting for bypass surgery, he reported acute abdominal pain, undergoing a third operation consisting of ileum resection and ileostomy. To avoid further intestinal infarction potentially triggering short bowel syndrome, he underwent simultaneous external iliac and superior mesenteric artery bypass using a prosthetic graft. Previous bilateral varicose vein stripping made vein grafts unavailable. Abdominal angina occurs if stenosis occurs in any visceral celiac, superior, and inferior mesenteric-arteries). Treatment involves endarterectomy or bypass surgery. In intraabdominal infection or simultaneous intestinal resection, vein grafts are preferred, but our case showed that prosthetic grafts may be used if handled with care.

Key words
abdominal angina, intestinal necrosis, prosthetic graft

Reprint requests
Kota Yamamoto Department of Surgery, Chigasaki Municipal Hospital
5-15-1 Honson, Chigasaki, 253-0042 JAPAN

Accepted
March 25, 2009

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