The Surgical Management of the Acute Ischemic Intestinal Syndrome

1Surgical Clinic I, County Hospital Timisoara, University of Medicine and Pharmacy Timisoara SUMMARY: The ischemic intestinal syndrome represents the totality of clinical manifestations caused by total or partial, abruptly or slowly reduction of the intestinal circulation. The diagnosis made by laparoscopy was very useful in critical patients with suspicion of mesenteric intestinal infraction but with an irrelevant clinical picture. Between 01.01.2003 and 01.07.2005 in First Clinic of Surgery from University Hospital Timisoara, there were 5549 patients which underwent operations. From this total 12 patients, representing 0,21%, underwent operations for intestinal infraction. All the patients were hospitalized and operated on emergency, after a minimum of biological and pre-operative investigations, which are compulsory before an operation of such magnitude. Most of the cases had intestinal resection (9 cases), with termino-terminal anastomosis (5 cases), and latero-lateral anastomosis (4 cases). In three cases, the intestinal resection was enlarged, in one case being associated with partial colon resection. Two cases had only explorative laparotomy. Postoperative the patients were on complex and sustained treatment. Large antibiotic doses are recommended preand postoperatively. Anticoagulation is administrated as soon as the intra-operative diagnosis is established. The immediate prognosis is better for the venous infraction. Mortality was present in 7 cases (58,33%).