Kalman P G, Johnston K W, Lipton I H
Can J Surg. 1981 Nov;24(6):634-7.
Intestinal ischemia should be suspected in any patient following aortic surgery who has pain out of keeping with the operation, postoperative diarrhea (with or without bleeding) or an unexplained metabolic acidosis. Ten such cases of intestinal ischemia were identified during a 10-year period at the Toronto General and Toronto Western hospitals. Six occurred following repair of a ruptured abdominal aneurysm, one followed elective aneurysmectomy and three followed elective bypass for occlusive disease. The overall mortality was 70%. Transmural bowel infarction was found in six patients (all died), while four patients had partial-thickness injury (one died, three had late strictures). Potentially preventable factors in each patient, either single or multiple, were identified and are discussed. Emphasis on ealy diagnosis is stressed, because once transmural necrosis had occurred the prognosis is poor.
在任何接受主动脉手术后出现与手术情况不符的疼痛、术后腹泻（伴或不伴出血）或不明原因代谢性酸中毒的患者中，均应怀疑存在肠道缺血。在多伦多综合医院和多伦多西部医院的10年期间，共确诊了10例此类肠道缺血病例。其中6例发生在破裂腹主动脉瘤修复术后，1例发生在择期动脉瘤切除术后，3例发生在因闭塞性疾病进行择期搭桥术后。总体死亡率为70%。6例患者出现透壁性肠梗死（均死亡），而4例患者有肠壁全层部分损伤（1例死亡，3例出现晚期狭窄）。确定并讨论了每名患者中单一或多个潜在可预防因素。强调早期诊断，因为一旦发生透壁性坏死，预后就很差。
