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Multiple organ dysfunction after mesenteric artery revascularization

T R Harward1, D L Brooks, T C Flynn

  • 1Department of Surgery, University of Florida College of Medicine, Gainesville 32610-0286.

Journal of Vascular Surgery
|September 1, 1993
PubMed
Summary
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Revascularization of chronically ischemic bowel causes significant multiple organ dysfunction, including liver, lung, and coagulation issues, potentially due to reperfusion injury. This highlights critical risks following mesenteric arterial repair.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Critical Care Medicine

Background:

  • Mesenteric arterial reconstruction for intestinal ischemia carries high risks.
  • Reperfusion of ischemic bowel can trigger systemic inflammatory responses.
  • Understanding post-reperfusion organ dysfunction is crucial for patient outcomes.

Purpose of the Study:

  • To determine the incidence of multiple organ dysfunction after reperfusion of chronically ischemic bowel.
  • To investigate the systemic effects of mesenteric revascularization.

Main Methods:

  • 18 patients with chronic mesenteric arterial occlusive disease underwent surgical revascularization (emergency or elective).
  • Hepatic, renal, pulmonary, and coagulation functions were monitored.
  • Bypass graft patency was confirmed in patients with complications.

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Main Results:

  • Postoperative hepatic function deteriorated significantly, with marked increases in transaminases and lactate dehydrogenase.
  • Platelet counts dropped in 11 patients, and 16 developed acute pulmonary insufficiency.
  • Multiple organ dysfunction occurred in 4 patients, leading to death; one additional death from myocardial infarction.

Conclusions:

  • Revascularization of chronically ischemic bowel results in significant multiple organ dysfunction.
  • Intestinal ischemia and reperfusion injury are likely causes of this dysfunction.
  • This underscores the need for careful patient monitoring and management post-mesenteric revascularization.