[Early diagnosis of acute mesenteric artery occlusion--clinical and experimental study]

This study was undertaken for the purpose of making early diagnosis of acute superior mesenteric artery occlusion (SMAO). (Clinical Study) This study included 16 patients with SMAO. The early diagnoses by clinical, laboratory, echographic and radiologic findings which were commonly obtained in the cases of abdominal emergency, were difficult. Angiography was useful method for its diagnosis. But in its early stage, we could hardly determine which patient was subject to angiography, therefore non-invasive and simple screening modelity is needed for its early diagnosis. (Experimental Study) Portal blood flow (PVF) is considered to decrease when superior mesenteric artery (SMA) is occluded, because SMA is a main feeder of portal vein. If SMAO has specific portal hemodynamics, its early diagnosis will be possible by non-invasive PVF measurement using an ultrasonic duplex system (PD). We investigated the portal hemodynamic changes in experimental SMAO, peritonitis and ileus using 24 mongrel dogs. Our results showed that PVF to cardiac output ratios (PCR) of SMAO models were under 10% and in contrast, those of others were over 10%. So SMAO models were distinguishable from others. These suggested that PCR measured by PD and echocardiography was an useful indicator of early diagnosis of SMAO.