[Blood flow disturbance in digestive organs--a viewpoint of vascular surgery]

Various blood flow disturbances in intraabdominal digestive organs were studied clinically and experimentally from a viewpoint of vascular surgery. Acute gastric mucosal lesion may occur due to ischemia and reperfusion injury of the gastric mucosa. Bleeding from stomach ulcer may be rarely caused by consumption coagulopathy along with aortic aneurysm. Heparin therapy was successful to interrupt it. Gastrectomy is not indicated for such condition but aneurysm should be repaired. Portal vein reconstruction for the radical resection of hepatic, biliary and pancreatic cancers should be carefully made, because early or late stenosis occurs frequently, and they may connect to early or late morbidities or mortalities. On the other hand, resection and replacement of the suprarenal vena cava invaded by the retroperitoneal malignant tumor may be safely carried out. For the acute mesenteric arterial occlusion, early diagnosis and arterial reconstruction are essential to save catastrophe. Positive Doppler sound on the vasa recta seems to be the most reliable parameter for assessing bowel viability. Approach from the proximal large arteries is recommended for uncontrollable intraperitoneal bleeding.