ACUTE MESENTERIC VASCULAR OCCLUSION - ANALYSIS OF 39 PATIENTS

Objective: To study the factors that influence mortality and long term outcome of patients with acute mesenteric vascular occlusion. Design: Retrospective study. Setting: University hospital, Kanazawa, Japan. P atients: Thirty-nine patients treated between 1978 and 1995 for acute mesenteric vascular occlusion. Interventions: 34 patients underwent la parotomy. Bowel was resected in 29 patients, and primary anastomosis w as done in 20. The occluded vessel was revascularised in 5 patients. M ain outcome measures: mortality, short bowel syndrome and long term su rvival.Results: 25 patients had arterial occlusions, and 8 venous. In the remaining 6, the occluded vessel was not identified. 11 Patients d eveloped renal failure, 11 respiratory failure, and 10 disseminated in travascular coagulation (DIG). Twelve patients died within 30 days. Th e factors associated with early death were acidosis and high serum amy lase activity. 9 Patients developed the short bowel syndrome. Survival was 49% at 1 year, and 34% at 5 years. Conclusion: Mortality was high er in patients with advanced peritonitis. Mesenteric revascularisation should be attempted to avoid the short bowel syndrome.