In Sutu Right Gastroepiploic Artery Bypass Graft for Mesenteric Ischemia of the Superior Mesenteric Artery

Kenichiro Uemura, Yoshiaki Murakami, Takashi Yokoyama^*, Yoshio Takesue, Eiso Hiyama^*, Yuji Imamura, Tetsuya Kanehiro, Masaru Sasaki, Masahiko Morifuji and Taijiro Sueda

First Department of Surgery and ^*Department of General Medicine, Faculty of Medicine, School of Medicine, Hiroshima University

We report a successful in situ right gastroepiploic artery (RGEA) bypass graft for ischemia of the superior mesenteric artery. A 47-year-old man admitted to another clinic for acute abdominal pain underwent exploratory laparotomy that revealed severe ischemia of the ileum with marginal arterial flow preserved. Following conservative therapy, the man was transferred to our hospital diagnosed with superior mesenteric artery (SMA) occlusion. Mesenteric angiography showed the SMA to be totally occluded distally from the middle colic artery and collateral vessels from the middle colic artery and the first jejunum artery to the ileum. In situ RGEA-SMA bypass was successful and recovery uneventful. Angiography 1 month later showed good RGEA bypass graft patency. This is to our knowledge the first documented case of successful RGEA used as an in situ arterial bypass graft for superior mesenteric ischemia.

Key words
mesenteric ischemia, superior mesenteric artery occlusion, in situ right gastroepiploic artery graft

Reprint requests
Kenichiro Uemura First Department of Surgery, Faculty of medicine, School of Medicine, Hiroshima University 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 JAPAN

Accepted
September 19, 2001

To read the PDF file you will need Abobe Reader installed on your computer.