Prediction of small bowel viability using Doppler ultrasound. Clinical and experimental evaluation.

The operative determination of small bowel viability following strangulation obstruction or mesenteric vascular occlusion remains a problem. In the canine model, Doppler ultrasound was used to predict intestinal viability in segments of small bowel subjected to mesenteric venous occlusion. This was compared with small bowel electromyography and the short- and long-term clinical courses. If flow was consistently heard on the antimesenteric border, the bowel remained viable, had return of slow waves on electromyography, and did not develop strictures during a six-month follow-up period. Four clinical cases are presented where Doppler ultrasound was utilized to supplement the usual methods of determining small bowel viability. Doppler ultrasound is a rapid, noninvasive method of determining small bowel viability.