van der Waaij L A, van der Ven A J, Jörning P J, Nelis G F, Geelkerken R H
Afd. Interne Geneeskunde, Sophia Ziekenhuis, Zwolle.
Ned Tijdschr Geneeskd. 1998 Nov 28;142(48):2609-13.
Three patients, a man aged 50 years and two women aged 46 and 45 years, with abdominal pains and an undistended abdomen, were found to have acute mesenteric ischaemia. The causes were: unknown, a thrombus in the descending aorta and severe atherosclerosis, respectively. In the male patient, only 30 cm of vital small intestine ultimately remained; in one woman embolectomy sufficed, in the other, resection of a limited portion of the jejunal tract. All three patients fully recovered. Acute mesenteric ischaemia is a potentially lethal disease. Diagnosis in the first reversible phase makes full recovery of the intestine possible. This may be difficult since the clinical signs and symptoms are not specific in this phase and invasive diagnostic procedures (angiography) are required for accurate diagnosis. By making an angiogram of the mesenteric vessels in each patient with severe abdominal pain, no signs of peritonitis and leukocytosis, without another diagnosis, reversible mesenteric ischaemia can be diagnosed and a vascular surgical reconstruction can be planned.
三名患者，一名50岁男性和两名分别为46岁及45岁的女性，有腹痛症状且腹部无膨隆，被诊断为急性肠系膜缺血。病因分别为：不明、降主动脉血栓形成和严重动脉粥样硬化。在男性患者中，最终仅剩下30厘米的重要小肠；一名女性患者行栓子切除术即可，另一名女性患者则切除了有限部分的空肠。所有三名患者均完全康复。急性肠系膜缺血是一种潜在致命性疾病。在首个可逆阶段进行诊断可使肠道完全恢复。这可能具有挑战性，因为在此阶段临床体征和症状并不特异，且准确诊断需要进行侵入性诊断程序（血管造影）。对于每一名有严重腹痛、无腹膜炎体征和白细胞增多且无其他诊断的患者，通过进行肠系膜血管造影，可诊断出可逆性肠系膜缺血，并可规划血管外科重建手术。
