Baeshko A A, Klumuk S A, Iushkevich V A
Angiol Sosud Khir. 2004;10(4):99-113.
Acute disorder of mesenteric circulation (ADMC) is an emergency pathology of the abdominal organs. It occurs in 0.2% of general surgery patients. A total of 346 patients with verified (before, during operation and/or on autopsy) diagnosis of ADMC were analyzed retrospectively. There were 217 (62.7%) women and 129 (37.3%) men. The mean age of the patients was 68.4+/-3.6 years. In 50.7% of patients, ADMC was induced by thrombosis of the unpaired visceral branches of the abdominal aorta, in 29.1% -- by embolism of the superior mesenteric artery (SMA), in 7.8% -- by thrombosis of the portomesenteric bed, in 7.5% -- by non-occlusion mesenteric ischemia (NOMI), and in 4.9% by diseases of the parietal vessels of the bowel. The most prevalent risk factors of ADMC were: atherosclerosis of the aorta and its branches, previous reconstructions for occlusion-stenotic arterial lesions, episodes of arterial embolism in the anamnesis, congenital and acquired hemostatic disorders, oral contraception, thromboses of the deep veins and/or pulmonary embolism in the anamnesis, operations on the abdominal organs, different types of acute end chronic heart failure. In SMA thrombosis, occlusion most frequently affects the orifice (93.5%) and initial segment of the great vessel, In embolism it occurs before or at the level of the middle colic artery (in 57.9%). Disseminated bowel necroses are more frequently encountered in occlusions of the arterial bed (87.7% in thromboses and 83.3% emdolism) than in the venous system (8.3%).