A Clinical Study on the Diagnosis and the Treatment of Mesenteric Arterial Occlusion Compared with Strangulation Ileus

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 25; no. 5; pp. 1228 - 1233
• Main Authors: Chikamori, Fumio, Aoyagi, Hiroyuki, Takase, Yasuhiro, Shibuya, Susumu, Sharma, Niranjan, Iwasaki, Yoji
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 1992
• Subjects: massive bowel resection; mesenteric arterial occlusion; strangulation ileus; urokinase infusion
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.25.1228

Twelve cases of mesenteric arterial occlusion were subjected to a clinical study to establish early diagnosis, and treatment modality. The results were compared with 27 cases of strangulation ileus for diagnosis, mode of treatment and prognosis. There was a significant difference (p<0.01) between mesenteric arterial occlusion and strangulation ileus for: the average age (69±9 vs. 54±21 years), history of laparotomy (17% vs. 74%), associated heart disease (75% vs. 22%), abdominal tenderness (58% vs. 96%), rebound tenderness (25% vs. 78%), muscle guarding (8% vs. 70%), elevated LDH (≥500 IU/l) (92% vs. 26%), massive bowel resection rate (70% vs. 11%), and mortality rate (50% vs. 4%), respectively. The massive bowel resection rate and mortality rate were higher in patients with mesenteric arterial occlusion than in those with strangulation ileus. Therefore, to make an early diagnosis and start treatment early, angiography should be performed in all elderly patients with ileus with heart disease, slight abdominal findings, LDH of ≥500 lU/l, and negative history of laparotomy.