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Related Experiment Videos

Visceral ischemia following aortic surgery.

T Jonung1, E Ribbe, L Norgren

  • 1Department of Surgery, Lund University, Sweden.

VASA. Zeitschrift Fur Gefasskrankheiten
|January 1, 1991
PubMed
Summary

Intestinal ischemia is a rare but deadly complication following aortic surgery. Ruptured aortic aneurysms identify patients at risk, but no other preoperative signs reliably predict this complication.

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Area of Science:

  • Vascular Surgery
  • Gastrointestinal Surgery
  • Surgical Complications

Background:

  • Intestinal ischemia is a rare (1-5%) but often fatal (greater than 50%) complication after aortic surgery.
  • This study analyzes patients reoperated for bowel ischemia following abdominal aortic operations.

Purpose of the Study:

  • To identify risk factors and patient profiles associated with intestinal ischemia after aortic surgery.
  • To evaluate the predictive value of preoperative investigations and clinical signs for identifying at-risk patients.

Main Methods:

  • Retrospective analysis of 17 patients reoperated for bowel ischemia between 1974 and 1987.
  • Review of preoperative investigations, intraoperative findings, and clinical data.

Main Results:

  • Ruptured aortic aneurysm was identified as a significant risk factor.
  • Preoperative inferior mesenteric artery (IMA) patency was noted in 3 patients, occlusion in 5.
  • Bloody diarrhea and peritonitis were common findings before reoperation; elevated creatinine was the most frequent lab abnormality.

Conclusions:

  • Patients undergoing surgery for ruptured aortic aneurysms are at higher risk for intestinal ischemia.
  • No other reliable preoperative symptom or sign could identify patients at risk.
  • Intraoperative assessment of intestinal blood flow is crucial for selective vascular reconstruction.

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