Karmody A M, Jordan F R, Zaman S N
Arch Surg. 1976 Sep;111(9):972-5. doi: 10.1001/archsurg.1976.01360270044008.
We report here an experience with five patients, aged 58 to 70, suffering gangrene of the left colon after spontaneous inferior mesenteric artery occlusion. All cases were the result of arteriosclerosis; in two, small aortic aneurysms were present and might have been responsible for emboli to the inferior mesenteric artery. The dead bowel was resected in all patients; three patients survived. No primary anastomoses were done and they are not recommended. Because ligation of the patent inferior mesenteric artery has been done so often without ill effects during aortic surgery, the collateral circulation to the left colon can be considered excellent. Gangrene is therefore rare and requires major interference with collateral circulation by emboli or arteriosclerotic occlusion. The clinical symptoms and signs may be confusing.
我们在此报告5例年龄在58至70岁之间的患者的经历，这些患者在肠系膜下动脉自发性闭塞后发生左半结肠坏疽。所有病例均由动脉硬化所致；其中2例存在小的主动脉瘤，可能是肠系膜下动脉栓塞的原因。所有患者均切除了坏死肠段；3例患者存活。未进行一期吻合，也不建议进行一期吻合。由于在主动脉手术中经常结扎通畅的肠系膜下动脉而无不良影响，因此可认为左半结肠的侧支循环良好。因此，坏疽很少见，需要栓子或动脉硬化闭塞对侧支循环造成严重干扰。临床症状和体征可能令人困惑。
