Extraordinary revascularization of acute-on-chronic intestinal ischemia

Acute-on-chronic mesenteric ischemia is rare, symptomatic manifestation of arteriosclerosis, and there are important gaps in our knowledge and recognition of this potentially lethal condition. Careful exploration of anamnestic history and angiography remain cornerstones of early diagnosis. Prognosis crucially depends on rapid diagnosis and surgical management, to prevent, or at least to minimize bowel infarction. Delay in surgical intervention is associated with increasing mortality that is still high and varies from 60 to 100%. The prognosis dramatically improves if revascularization can be achieved prior to intestinal infarction. Patients surviving extended intestinal resection may develop short gut syndrome. Case rapport of acute-on-chronic mesenteric ischemia with extraordinary approach for superior mesenteric artery revascularisation is described. Literature review is presented. MEDICINA (2002) Vol. 38, No. 7 http://medicina.kmu.lt