Analyze the Optimal Management of Superior Mesenteric Artery (SMA) Occlusion

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 34; no. 3; pp. 587 - 591
• Main Authors: Takahashi, Tetsuya, Takemoto, Masaaki
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 31.03.2014; 日本腹部救急医学会
• Subjects: 上腸間膜動脈閉塞症; 腸管切除術; 血栓吸引術; 血栓溶解療法
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem.34.587

Subjects and methods：The characteristics of patients with SMA occlusion in this hospital between October 1, 2005 and September 30, 2012 were investigated retrospectively. Results: There were 10 cases of SMA occlusion, of which 4 were treated with interventional radiology (IVR), 2 required additional enterectomy after IVR treatment, and 4 were treated with enterectomy. The time from the onset to diagnosis was significantly shorter (6.8 hours vs. 29.1 hours, p<0.05) and the serum CRP significantly lower (0.5mg/dL vs. 13.9mg/dL, p<0.05) in the IVR group which showed improvement in response to the treatment (n=2) than in the intestinal necrosis group (n=8). The cutoff values of the two parameters were 2 hours and 0.2mg/dL, respectively. There were no abnormal findings on abdominal CT in the IVR group. Conclusion: IVR is considered as a worthwhile initial treatment modality in cases of SMA occlusion when the interval from onset to diagnosis is under 2 hours, the serum CRP is ≤0.2mg/dL, and abdominal CT reveals no abnormalities.