Diagnostic investigation and special treatment of chronic abdominal ischaemia.

Chronic abdominal ischaemia (C.A.I.)--abdominal angina--is a neglected gastrointestinal vascular condition, with chronic complaints and symptoms for the patient posing severe diagnostic and therapeutic problems. In the angiologic department of the Interunion Scientific Center of Surgery during the past 25 years, chronic intestinal ischaemia was diagnosed in 150 patients, a number representing 2.5% of the whole population with pathology form the aorta and its branches. Etiological factors of disease of the celiac axis, superior mesenteric artery and inferior mesenteric artery occlusion were the intravascular factors in 99 patients, atherosclerosis in 63 and nonspecific aorto-arteritis in 36. Extravascular factors: median arcuate ligament of the diaphragm, celiac plexus, periarterialfibrous, nerve fibers and tumor of pancreas were found in 51 patients. Of the 150 patients with C.A.I., 84 (56%) were operated and 87 operations were performed; of these 6 (4%) had a transluminal dilatation. A left thoraco-diaphragmatic approach to these vessels, via a lumbar incision through the last intercostal space in 62 patients was carried out. In those cases where the operation on the inferior mesenteric artery was combined with an operation on the abdominal aorta, the vessels were approached through a typical laparotomy (16 patients). In C.A.I. we perform 2 types of operations: partially reconstructive (decompressive) and reconstructive operations. Partially reconstructive (decompressive) operations were performed in case of compression of unpaired branches of the abdominal aorta in order to free the artery from extraluminal causes of pressure.(ABSTRACT TRUNCATED AT 250 WORDS)