Williams L F
Vanderbilt University School of Medicine, Nashville, Tennessee.
Surg Clin North Am. 1988 Apr;68(2):331-53. doi: 10.1016/s0039-6109(16)44481-6.
Mesenteric ischemia secondary to vascular disease remains a significant problem in patients presenting with acute abdominal conditions, especially if they are elderly. Although rare, it is nevertheless an important and perhaps increasing cause of death or significant morbidity. Occasionally, it may be a mode of dying, but more often, it is the reason for death. Individual cases can manifest an almost overwhelming spectrum from chronic to acute, mild to catastrophic, arterial to venous, occlusive to hemodynamic, extensive to limited, or precisely diagnosed to accidentally found. Treatment principles are well defined, but continued refinement of supportive therapies of several types is occurring. In contrast, improved screening tests that can lead to early specific etiologic diagnosis remain at the experimental stage. Thus, good "clinical suspicion" is foremost and essential.
血管疾病继发的肠系膜缺血仍然是急性腹部疾病患者面临的一个重大问题，尤其是老年患者。尽管罕见，但它仍然是一个重要的、可能在增加的死亡或严重发病原因。偶尔，它可能是一种死亡方式，但更常见的是，它是死亡的原因。个别病例可呈现出从慢性到急性、从轻症到灾难性、从动脉性到静脉性、从阻塞性到血流动力学性、从广泛到局限、或从精确诊断到偶然发现的几乎压倒性的范围。治疗原则已明确界定，但几种类型的支持性疗法仍在不断完善。相比之下，能够导致早期特异性病因诊断的改进筛查试验仍处于实验阶段。因此，良好的“临床怀疑”最为重要且必不可少。
