J.Jpn. Surg. Soc.. 87(9): 1098-1100, 1986

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Report on the annual meeting

THE SURGICAL TREATMENT FOR ACUTE INTESTINAL ISCHEMIA BY EMBOLI

During the period of last 8 years, we have experienced total of 11 surgeries for acute intestinal ischemia by emboli or thrombosis. Their background diseases to cause the intestinal ischemia were emboli in 9, mesentheric thrombosis and circulatory failure in one, respectively. The source of emboli were originated from atrial fibrillation in 2, valvular heart disease in 2, combined with valvular disease and sick sinus syndrome in one and associated with cardiac catheterization in two patients. The thrombosis was occurred in a patient with shock and dehydration.
A patient who showed small bowel necrosis was observed in acute phase of DeBakey type IIIb of aortic dissection where abdominal aorta was occluded and meseptheric circulation was impaired preoperatively. The definitive diagnosis was established by angiographic studies in half of patients, however, rest of them were operated by only clinical symptoms and findings. Surgical results were poor, and only 4 survived. These survivors had localized type of intestinal necrosis, on the contrary with extensive necrosis of small or large bowel or both, none survived. The embolectomies by Fogarty catheter only were also not successful. We emphasize the importance of early diagnosis by means of angiographic study as well as prompt surgical exploration.

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