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Traumatic injury to the superior mesenteric artery
J A Asensio1, J D Berne, S Chahwan
1Department of Surgery, University of Southern California, and the Los Angeles County and the University of Southern California Medical Center, 90033-4525, USA.
American Journal of Surgery
|October 20, 1999
Summary
Superior mesenteric artery (SMA) injuries are highly lethal, often caused by exsanguination. Both Fullen's anatomical zones and the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) correlate with mortality in SMA injury patients.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Surgical Outcomes
Background:
- Superior mesenteric artery (SMA) injuries are rare but associated with extremely high mortality rates.
- Understanding injury patterns and classification systems is crucial for predicting outcomes.
Purpose of the Study:
- To review institutional experience with SMA injuries.
- To evaluate the predictive value of Fullen's classification (anatomical zone and injury grade).
- To correlate the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) with mortality.
Main Methods:
- Retrospective study of patients with SMA injuries over a 65-month period.
- Analysis of injury mechanisms, surgical management, and associated injuries.
- Correlation of mortality with Fullen's classification and AAST-OIS grades.
Main Results:
- Overall mortality for SMA injuries was 54% (19 of 35 patients).
- Penetrating injuries (77%) were more common than blunt injuries (23%).
- Mortality correlated with Fullen's zones and AAST-OIS grades, but not Fullen's ischemia grade.
Conclusions:
- SMA injuries are highly lethal, with exsanguination being a primary cause of death.
- Increased numbers of associated vascular injuries worsen mortality.
- Fullen's anatomical zones and AAST-OIS are valuable tools for predicting mortality in SMA injuries.