Intestinal ischemia - the basics

Introduction: In this review the physiology of the intestinal circulation o f importance for the understanding of intestinal ischemia is briefly outlin ed. Perspectives: The potential threat of massive intestinal vasoconstricti on causing nonocclusive intestinal ischemia is discussed, as is the clinica l importance of the reperfusion component of the ischemic injury. The clini cal causes of intestinal ischemia are outlined. The delay in the usual clin ical diagnostic process and its severe consequences are emphasized. Emphasi s is made to discuss the special situation with sigmoid gangrene following surgery for ruptured aortic aneurysm. Laparotomy upon clinical suspicion of intestinal ischemia is generally recommended. The various therapeutic surg ical measures available if diagnosis is made before massive intestinal gang rene are discussed.