J.Jpn. Surg. Soc.. 100(5): 352-356, 1999

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Feature topic

VASCULAR SURGICAL APPROACH TO MESENTERIC ISCHEMIA

With the increase in the number of the elderly, the incidence of mesenteric ischemia should also increase. However, clinical diagnosis of this critical condition is difficult. Angiography should be performed promptly in patients with suspected mesenteric ischemia.
Restoration of mesenteric circulation is the first step in the treatment. Endovascular treatment using a catheter for direct thrombolysis is recommended immediately after the diagnostic angiography. In addition to endovascular treatment, surgical reconstruction can be performed in patients with imperfect circulatory restoration. Intraoperative evaluation of intestinal viability must be performed after blood flow reconstruction using an accurate technique such as Doppler flowmetry, and then a precise decision on bowel resection and safety anastomosis can be mode.

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