Barbieri A G, Caldarola G
Chir Ital. 1978 Oct;30(5):607-17.
The authors present a series of 14 cases of intestinal or colonic obstruction due to arterial ischema (7 cases) or mesenteric vein thrombosis (7 cases), for which they provide an analysis of pathogenesis, clinical aspects, surgical strategy, and intensive care. Mortality was 87.5% in cases of arterial origin and 42.8% in those of venous origin. The authors stress the need for diagnosing intestinal infarction right from the start, relying on clinical intuition and with the help of only a few clinical symptoms and objective signs. Surgically speaking, the best chance of survival is afforded by restoration of arterial or venous patency associated with whatever resection of the ileum or colon the anatomical situation may require.
作者报告了一系列14例因动脉缺血(7例)或肠系膜静脉血栓形成(7例)导致的肠梗阻或结肠梗阻病例,并对其发病机制、临床情况、手术策略及重症监护进行了分析。动脉源性病例的死亡率为87.5%,静脉源性病例的死亡率为42.8%。作者强调,从一开始就需要依靠临床直觉,并借助仅有的一些临床症状和客观体征来诊断肠梗死。从手术角度而言,恢复动脉或静脉通畅并根据解剖情况对回肠或结肠进行必要切除,能提供最佳的生存机会。