Givel J C
Service de Chirurgie A, CHUV, Lausanne.
Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1990:335-40.
Reconstructive surgery of the aortoiliac junction often requires interruption of the inferior mesenteric artery. Ischaemic colitis following this type of surgery occurs in 15-20% of cases, most often in the splenic flexure and the sigmoid colon. It is caused by general haemodynamic factors and/or atherosclerotic changes in the intestinal arteries. Clinical symptoms are often subtle or atypical and the diagnosis is difficult. However intestinal ischaemia causes considerable morbidity and mortality. Around 1000 aortoiliac reconstructive procedures were performed, with a 2.8% incidence of post-operative colonic ischaemia. The two most important risk factors were hypovolemia and ligation of the inferior mesenteric artery.
腹主动脉-髂动脉交界处的重建手术常常需要阻断肠系膜下动脉。这类手术后缺血性结肠炎的发生率为15% - 20%,最常发生于脾曲和乙状结肠。它是由全身血流动力学因素和/或肠道动脉的动脉粥样硬化改变所引起。临床症状往往不明显或不典型,诊断困难。然而,肠道缺血会导致相当高的发病率和死亡率。共进行了约1000例腹主动脉-髂动脉重建手术,术后结肠缺血的发生率为2.8%。两个最重要的危险因素是血容量不足和肠系膜下动脉结扎。