Clinical experience with surgical treatment of chronic intestinal ischaemia

Fourteen patients suffering from abdominal angina have been operated on with different revascularization techniques. Preoperatively all of them had classical symptoms: postprandial pain and all except two had remarkable weight loss. There were six patients with isolated coeliac axis stenosis and in eight cases there were two or three diseased vessels. Liberation and reconstruction of the coeliac axis were carried out in six cases. Aorto-hepatic by pass graft was performed in three patients. Reinsertion of SMA was done in four and reinsertion of IMA in one case. Reconstruction of SMA with a by pass graft was carried out also in one case. There was no operative mortality. One of the patients died five weeks postoperatively at home from myocardial infarction. Another patient operated on in 1965 died seven years later at the age of 78 from myocardial infarction. He had had no further symptoms of abdominal angina postoperatively. The remaining 12 patients were relieved of their symptoms after the operation. They have been followed up for a mean of 5.5 years. The good long term results of arterial reconstructions in contrast to the poor prognosis without operation, favours early operation. The importance of early diagnosis and the importance of early operative treatment are emphasized.