[Surgery of chronic intestinal ischemia (author's transl)]

Chronic intestinal ischemia has to be diagnosed by an interdisciplinary approach. Clinical symptoms are unrevealing; usually the internist and the radiologist make the diagnosis after numerous special examinations and arteriography of the abdominal aorta in two planes. Indications for conservative treatment vs. surgery have to be discussed between the specialists involved, that is the internist, the radiologist, the anesthesist and the surgeon. Surgical problems in cases with chronic vascular occlusions are problems of vascular surgery and surgery may be well planned and performed electively. Acute occlusions of intestinal vessels however require mostly immediate surgery of the intestine itself which has to be performed as an emergency procedure because of the impending organ necrosis and complications; this is demonstrated in the case of ischemic colitis.