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Left Colon Gangrene After Acute Inferior Mesenteric Artery Occlusion

Left Colon Gangrene After Acute Inferior Mesenteric Artery Occlusion Abstract • 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. (Arch Surg 111:972-975, 1976) References 1. Tiedeman, quoted by Virchow R: Uber die akute Entzundung der Arterien . Virchow Arch Pathol Anat 1:272-275, 1847.Crossref 2. Virchow R: Uber die akute Entzundung der Arterien . Virchow Arch Pathol Anat 1:272-275, 1847.Crossref 3. Elliott JW: The operative relief of gangrene of intestine due to occlusion of the mesenteric vessels . Ann Surg 21:9-11, 1895.Crossref 4. Stewart GD, Sweetman WR, Westfall E, et al: Superior mesenteric artery embolectomy . Ann Surg 151:274-278, 1960.Crossref 5. Mavor GE, Galloway JMD, Karmody AM: Survival After Superior Mesenteric Arterial Occlusion: Clinical Reports . Edinburgh, Royal College of Surgeons, 1968. 6. Hollingshead WH: Anatomy for Surgeons . New York, Harper & Row Inc, 1969, vol 2, pp 497-498. 7. Kahn P, Abrams H: Inferior mesenteric arterial patterns: An angiographic study . Radiology 82:429-442, 1964.Crossref 8. Mavor GE: Clinical Surgery: Mesenteric Vascular Occlusion . C Rob, R Smith (eds), London, Butterworth & Co, 1966, vol 10. 9. Carter R, Vannix R, Hinshaw DB, et al: Acute inferior mesenteric vascular occlusion: A surgical syndrome . Am J Surg 98:271-275, 1959.Crossref 10. Wrate RM: A case of acute inferior mesenteric vascular occlusion . Br J Surg 58:8, 632-633, 1971.Crossref 11. Marston A: Viability of the intestine . Arch Surg 100:744-747, 1970.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Left Colon Gangrene After Acute Inferior Mesenteric Artery Occlusion

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Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1976.01360270044008
Publisher site
See Article on Publisher Site

Abstract

Abstract • 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. (Arch Surg 111:972-975, 1976) References 1. Tiedeman, quoted by Virchow R: Uber die akute Entzundung der Arterien . Virchow Arch Pathol Anat 1:272-275, 1847.Crossref 2. Virchow R: Uber die akute Entzundung der Arterien . Virchow Arch Pathol Anat 1:272-275, 1847.Crossref 3. Elliott JW: The operative relief of gangrene of intestine due to occlusion of the mesenteric vessels . Ann Surg 21:9-11, 1895.Crossref 4. Stewart GD, Sweetman WR, Westfall E, et al: Superior mesenteric artery embolectomy . Ann Surg 151:274-278, 1960.Crossref 5. Mavor GE, Galloway JMD, Karmody AM: Survival After Superior Mesenteric Arterial Occlusion: Clinical Reports . Edinburgh, Royal College of Surgeons, 1968. 6. Hollingshead WH: Anatomy for Surgeons . New York, Harper & Row Inc, 1969, vol 2, pp 497-498. 7. Kahn P, Abrams H: Inferior mesenteric arterial patterns: An angiographic study . Radiology 82:429-442, 1964.Crossref 8. Mavor GE: Clinical Surgery: Mesenteric Vascular Occlusion . C Rob, R Smith (eds), London, Butterworth & Co, 1966, vol 10. 9. Carter R, Vannix R, Hinshaw DB, et al: Acute inferior mesenteric vascular occlusion: A surgical syndrome . Am J Surg 98:271-275, 1959.Crossref 10. Wrate RM: A case of acute inferior mesenteric vascular occlusion . Br J Surg 58:8, 632-633, 1971.Crossref 11. Marston A: Viability of the intestine . Arch Surg 100:744-747, 1970.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1976

References