Haga M, Sasajima T, Asada H, Azuma N, Morimoto N, Kubo Y
First Department of Surgery, Asahikawa Medical College, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Jan;41(1):93-6.
Two cases of an extensive bowel infarction occurred during Intraaortic Balloon Pumping (IABP) are reported. In the first, an acute myocardial infarction was seen suddenly on the seventh postoperative day following arterial reconstruction of the right lower leg and his condition required IABP support. Five day after beginning of IABP, severe symptoms suggesting peritonitis appeared, and laparotomy revealed an extensive infarction of small bowel and sigmoid colon. In the second, the patient required IABP support for weaning from cardiopulmonary bypass after completion of coronary artery bypass grafting. A severe peritonitis was caused by an extensive infarction of small and large intestine during two days of IABP support. Cholesterol emboli were found in the small bowel arteries of the case 1 at microscopic examinations of the autopsy specimen. Both patients died of cardiopulmonary failure and renal failure respectively, though necrotic intestine were resected. Circulatory support using IABP should not be selected, when a patient has severe arteriosclerotic lesions of the aorta.
本文报告了两例在主动脉内球囊反搏（IABP）期间发生广泛肠梗死的病例。第一例，在右小腿动脉重建术后第七天突然发生急性心肌梗死，患者病情需要IABP支持。IABP开始五天后，出现提示腹膜炎的严重症状，剖腹探查发现小肠和乙状结肠广泛梗死。第二例，患者在冠状动脉搭桥术后需要IABP支持以脱离体外循环。在IABP支持的两天内，小肠和大肠广泛梗死导致严重腹膜炎。尸检标本显微镜检查发现病例1的小肠动脉中有胆固醇栓子。尽管切除了坏死肠段，但两名患者分别死于心肺衰竭和肾衰竭。当患者有严重的主动脉动脉硬化病变时，不应选择使用IABP进行循环支持。
