MASSIVE INTESTINAL INFARCTION - POSSIBLE ROLE OF OSTIAL STENOSIS OF DIGESTIVE-TRACT ARTERIES

A case is reported of a 35-year-old woman who sustained a massive inte stinal infarction requiring a total resection of small intestine and t he colon, with a terminal duodenostomy. Preoperative arteriography and intraoperative findings at laparotomy showed a thrombosis of coeliac trunc, superior and inferior mesenteric arteries, originating possibly from a non atheromatous ostial stenosis of these vessels. The blood s upply to stomach, duodenum, liver and spleen was maintained through co llaterals from diaphragm, Postoperatively a dehiscence of duodenostomy suture occurred with a spontaneous favourable outcome. The closure of external duodenostomy orifice required an endoscopic aspirational gas trostomy. The patient was discharged with the perspective of intestina l transplantation, her nutrition being provided through an ambulatory parenteral nutritional support unit, A symptomatology of chronic mesen teric ischaemia should lead to an angiography of digestive arteries no t only with a diagnostic but also a possible therapeutic goal using an gioplasty techniques.