BOHN G L, CARROL K J
Gut. 1964 Aug;5(4):363-4. doi: 10.1136/gut.5.4.363.
This paper reports a successful superior mesenteric embolectomy. The possibility of successful surgical treatment makes its recognition particularly important. In any patient with a known history of cardiovascular disease who presents a sudden severe abdominal pain of obscure origin this diagnosis must be entertained. The pain at first is colicky because of the severe peristalsis which is induced but when ischaemia is marked it then becomes constant. With the crises of pain in the early stages the blood pressure falls and then recovers with the cessation of pain and this intermittent shock was a feature in the patient reported. A plain radiograph of the abdomen in the early stages is characterized by the absence or minimal presence of air in both the small and large bowel giving the film a very clear appearance. Prompt exploration is needed.
本文报道了一例成功的肠系膜上动脉栓子切除术。成功进行手术治疗的可能性使得对其的认识尤为重要。对于任何有心血管疾病史且突然出现原因不明的严重腹痛的患者,都必须考虑这一诊断。起初,由于诱发了严重的肠蠕动,疼痛呈绞痛性质,但当缺血明显时,疼痛就会持续。在早期疼痛发作时,血压下降,随后随着疼痛停止而恢复,这种间歇性休克是所报道患者的一个特征。早期腹部平片的特点是小肠和大肠内气体缺失或极少,使片子看起来非常清晰。需要及时进行探查。