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Incentive breathing devices and chest physiopathy: a controlled therapy

J L Oulton, G M Hobbs, P Hicken

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |November 1, 1981
    PubMed
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    Intestinal ischemia after aortic surgery is a serious complication. Early diagnosis is crucial, as transmural bowel infarction leads to a poor prognosis, with a 70% overall mortality rate in identified cases.

    Area of Science:

    • Vascular Surgery
    • Gastroenterology
    • Abdominal Surgery

    Background:

    • Intestinal ischemia is a critical complication following aortic surgery.
    • Clinical indicators include severe abdominal pain, diarrhea, and metabolic acidosis.
    • A 10-year review identified 10 cases at Toronto General and Toronto Western hospitals.

    Purpose of the Study:

    • To identify and analyze cases of intestinal ischemia post-aortic surgery.
    • To determine the mortality and morbidity associated with this complication.
    • To highlight potentially preventable factors and emphasize early diagnosis.

    Main Methods:

    • Retrospective review of 10 patient cases over a 10-year period.
    • Analysis of surgical procedures preceding ischemia (ruptured aneurysm repair, elective aneurysmectomy, bypass for occlusive disease).

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  • Assessment of outcomes including mortality, bowel infarction extent, and late strictures.

    • Main Results:

    • Overall mortality was 70% (7 out of 10 patients).
    • Six patients with transmural bowel infarction all died.
    • Four patients with partial-thickness injury had one death and three late strictures.

    Conclusions:

    • Intestinal ischemia following aortic surgery carries a high mortality rate.
    • Early diagnosis is paramount, as transmural necrosis significantly worsens prognosis.
    • Identification of preventable factors is essential for improving patient outcomes.