Revascularization in treatment of mesenteric infarction

This study compares results of primary revascularization with primary intestinal resection in treatment of acute mesenteric artery occlusion in 48 surgical patients. All cases were verified by surgical exploration, angiography or autopsy. Fifteen occlusions were caused by mesenteric thrombosis and 33 by superior mesenteric artery embolization. Primary revascularization was done in 6 of 15 patients with arteriosclerotic mesenteric thrombosis. Total bowel salvage was achieved in 4 patients but no patient with mesenteric thrombosis treated by any method survived long term. Primary embolectomy was done in 11 patients with superior mesenteric artery embolization. Ttoal bowel salvage was achieved in 8 patients. Three of 11 patients died. Primary exploration and/or resection was done in 11 patients; 9 died. All 11 umoperated patients died. A continuation of attempts at mesenteric revascularization is advocated.