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[Surgical tactics in acute mesenteric artery occlusion]
1I. Chirurgischen Abteilung des Krankenhauses der Stadt Wien-Lainz.
Zentralblatt Fur Chirurgie
|January 1, 1988
Summary
Acute mesenteric embolism has a high mortality rate, especially in older patients. Early diagnosis and intervention are crucial, with serum lactate levels offering valuable prognostic insights.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Critical Care Medicine
Context:
- Acute mesenteric embolism is a surgical emergency with significant morbidity and mortality.
- Historical data from 1980-1988 reveals outcomes for 52 patients undergoing surgical interventions.
- The patient cohort predominantly consisted of elderly individuals (average age 75.8 years).
Purpose:
- To analyze the surgical outcomes and mortality rates associated with acute mesenteric embolism.
- To evaluate the effectiveness of different surgical strategies, including embolectomy and bypass.
- To assess the diagnostic and prognostic value of serum lactate levels in acute intestinal ischemia.
Summary:
- Exploratory laparotomy alone resulted in 100% mortality.
- Embolectomy from the superior mesenteric artery had a high mortality rate (75%).
- Resection of intestinal segments combined with embolectomy also showed high mortality (58%).
- Overall mortality for all 52 patients was 71.1%.
- Restitutional surgery, excluding exploratory laparotomy, had a mortality rate of 53.1%.
Impact:
- Serum lactate levels are identified as reliable diagnostic and prognostic indicators for acute intestinal ischemia.
- Normal lactate levels (1-2 mmol/l) differentiate non-ischemic abdominal conditions from ischemia.
- Elevated lactate levels (mean 8.88 mmol/l) are characteristic of mesenteric embolism.
- Findings underscore the severity of acute mesenteric embolism and the need for timely intervention and monitoring.