Scheppach W, Langenfeld H, Schultz G, Wittenberg G, Hahn D, Kochsiek K
Medizinische Klinik, Universität Würzburg.
Z Gastroenterol. 1995 Apr;33(4):214-8.
Four cases of acute gut ischemia in elderly patients due to non-occlusive disease (NOD) are presented. Bowel necrosis occurred after episodes of hypotension in the course of myocardial infarction, arrhythmias and sepsis. Symptoms and clinical findings were blurred by the underlying extraintestinal disease. Angiography showed coexistent atherosclerosis but no occlusion of the major celiac and mesenteric vessels. At laparotomy (three cases) or autopsy (one case) extensive small and large bowel necroses were detected. Early laparotomy (possibly preceded by laparoscopy) is recommended for patients with suspected acute gut ischemia even if angiography fails to reveal occlusion of the large splanchnic arteries.
本文报告了4例老年患者因非闭塞性疾病（NOD）导致的急性肠道缺血病例。在心肌梗死、心律失常和脓毒症过程中出现低血压后发生了肠坏死。潜在的肠道外疾病使症状和临床发现变得模糊不清。血管造影显示并存动脉粥样硬化，但主要腹腔干和肠系膜血管未发生闭塞。在剖腹手术（3例）或尸检（1例）中发现了广泛的小肠和大肠坏死。对于疑似急性肠道缺血的患者，即使血管造影未能显示大内脏动脉闭塞，也建议早期进行剖腹手术（可能先进行腹腔镜检查）。
