[Acute disorders of intestinal perfusion; a nonrigid abdomen may still be acute]

Three patients, a man aged 50 years and two women aged 46 and 45 years, with abdominal pains and an undistended abdomen, were found to have acute mesenteric ischaemia. The causes were: unknown, a thrombus in the descending aorta and severe atherosclerosis, respectively. In the male patient, only 30 cm of vital small intestine ultimately remained; in one woman embolectomy sufficed, in the other, resection of a limited portion of the jejunal tract. All three patients fully recovered. Acute mesenteric ischaemia is a potentially lethal disease. Diagnosis in the first reversible phase makes full recovery of the intestine possible. This may be difficult since the clinical signs and symptoms are not specific in this phase and invasive diagnostic procedures (angiography) are required for accurate diagnosis. By making an angiogram of the mesenteric vessels in each patient with severe abdominal pain, no signs of peritonitis and leukocytosis, without another diagnosis, reversible mesenteric ischaemia can be diagnosed and a vascular surgical reconstruction can be planned.