Kaczynski Jakub, Jaber Basel, Atherton Steve, Fligelstone Louis
ABM University Health Board, Department of Vascular Surgery, Morriston Hospital Swansea United Kingdom.
Interv Med Appl Sci. 2014 Jun;6(2):85-8. doi: 10.1556/IMAS.6.2014.2.5. Epub 2014 Jun 4.
Ischemic colitis is the most common form of an iatrogenic intestinal ischemia following an aortic surgery. It can be transient and self-limiting but, when severe, is associated with mortality even as high as 80%. Careful preoperative assessment can help to anticipate the need for the inferior mesenteric artery (IMA) reimplantation. Some patients lack the sufficient collateral blood supply to the colon and can benefit from the IMA reimplantation, which not only reduces the risk of postoperative colonic necrosis but also can be lifesaving. We report a case of a successful reimplantation of the IMA based on the careful preoperative planning. If unrecognized, this undoubtedly would lead to postoperative colonic ischemia. Therefore, we feel it is important to share our experience regarding the successful management of the presented case.
缺血性结肠炎是主动脉手术后医源性肠缺血最常见的形式。它可能是短暂的且具有自限性，但严重时甚至与高达80%的死亡率相关。仔细的术前评估有助于预测肠系膜下动脉（IMA）再植的必要性。一些患者缺乏足够的结肠侧支血供，可从IMA再植中获益，这不仅降低了术后结肠坏死的风险，还可能挽救生命。我们报告一例基于仔细术前规划成功进行IMA再植的病例。如果未被识别，这无疑会导致术后结肠缺血。因此，我们认为分享我们成功处理该病例的经验很重要。
