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Observations on the Diagnosis And Treatment of Obliterative Disease of the Visceral Branches Of the Abdominal Aorta

Observations on the Diagnosis And Treatment of Obliterative Disease of the Visceral Branches Of... Abstract AS THE surgical approach to mesenteric vascular disease has become more sophisticated, the investigation of symptoms and signs of bowel ischemia, or even of unexplained abdominal pain, has become more complete. The mesenteric circulation may now be studied in man either selectively or by abdominal aortography; these examinations are now accepted diagnostic procedures in such problems. By the selective technique, an elegance of definition of the small branches is attained which aortography rarely affords (Fig 1); but in the presence of total luminal occlusion, the selective method is not applicable. Our experience with mesenteric vascular disease has emphasized both the difficulties in diagnosis and management, and the gratifying results of appropriate therapy. It is the purpose of this paper to indicate the role of collateral pathways in intestinal ischemia, some of the pitfalls in its recognition, and the potential for cure. I. The Role of Collateral Pathways in Intestinal Ischemia References 1. Bernatz, P. E.: Necrosis of Colon Following Resection for Abdominal Aortic Aneurysms , Arch Surg 81:373, 1960.Crossref 2. Brolin, I., and Paulin, S.: Abnormal Communications Between Splanchnic Vessels , Acta Radiol 2:460, 1964. 3. Carter, R., et al: Acute Inferior Mesenteric Vascular Occlusion: Surgical Syndrome , Amer J Surg 98:271, 1959.Crossref 4. Drummond, H.: Some Points Relating to Surgical Anatomy of Arterial Supply of Large Intestine , Proc Roy Soc Med 7:185, 1913. 5. Dunphy, J. E.: Abdominal Pain of Vascular Origin , Amer J Med Sci 192:109, 1936.Crossref 6. Fry, W. J., and Kraft, R. O.: Visceral Angina , Surg Gynec Obstet 117:417, 1963. 7. Jackson, B. B.: Occlusion of Superior Mesenteric Artery , Springfield, Ill: Charles C Thomas, Publisher, 1963. 8. Kahn, P., and Abrams, H. L.: Inferior Mesenteric Arterial Patterns , Radiology 82:429, 1964.Crossref 9. Laufman, H.; Nora, P. F.; and Mittelpunkt, A. I.: Mesenteric Blood Vessels: Advances in Surgery and Physiology , Arch Surg 88:1021, 1964.Crossref 10. McKain, J., and Shumacker, H. B., Jr.: Ischemia of Left Colon Associated With Abdominal Aortic Aneurysms and Their Treatment , Arch Surg 76:355, 1958.Crossref 11. Morris, G. C., Jr., and DeBakey, M. E.: Abdominal Angina, Diagnosis and Treatment , JAMA 176:91, 1961.Crossref 12. Moskowitz, M.; Zimmerman, H.; and Felson, B.: Meandering Mesenteric Artery of Colon , Amer J Roentgen 92:1088, 1964. 13. Nanson, E. M.: Vascular Lesions Producing "Acute Abdomen," Surg Clin N Amer 40:1241, 1960. 14. Shaw, R. S.: Vascular Lesions of Gastrointestinal Tract , Surg Clin N Amer 39:1253, 1959. 15. Zuidema, G. D., et al: Superior Mesenteric Artery Embolectomy , Ann Surg 159:548, 1964.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Observations on the Diagnosis And Treatment of Obliterative Disease of the Visceral Branches Of the Abdominal Aorta

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Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1965.01320100140021
Publisher site
See Article on Publisher Site

Abstract

Abstract AS THE surgical approach to mesenteric vascular disease has become more sophisticated, the investigation of symptoms and signs of bowel ischemia, or even of unexplained abdominal pain, has become more complete. The mesenteric circulation may now be studied in man either selectively or by abdominal aortography; these examinations are now accepted diagnostic procedures in such problems. By the selective technique, an elegance of definition of the small branches is attained which aortography rarely affords (Fig 1); but in the presence of total luminal occlusion, the selective method is not applicable. Our experience with mesenteric vascular disease has emphasized both the difficulties in diagnosis and management, and the gratifying results of appropriate therapy. It is the purpose of this paper to indicate the role of collateral pathways in intestinal ischemia, some of the pitfalls in its recognition, and the potential for cure. I. The Role of Collateral Pathways in Intestinal Ischemia References 1. Bernatz, P. E.: Necrosis of Colon Following Resection for Abdominal Aortic Aneurysms , Arch Surg 81:373, 1960.Crossref 2. Brolin, I., and Paulin, S.: Abnormal Communications Between Splanchnic Vessels , Acta Radiol 2:460, 1964. 3. Carter, R., et al: Acute Inferior Mesenteric Vascular Occlusion: Surgical Syndrome , Amer J Surg 98:271, 1959.Crossref 4. Drummond, H.: Some Points Relating to Surgical Anatomy of Arterial Supply of Large Intestine , Proc Roy Soc Med 7:185, 1913. 5. Dunphy, J. E.: Abdominal Pain of Vascular Origin , Amer J Med Sci 192:109, 1936.Crossref 6. Fry, W. J., and Kraft, R. O.: Visceral Angina , Surg Gynec Obstet 117:417, 1963. 7. Jackson, B. B.: Occlusion of Superior Mesenteric Artery , Springfield, Ill: Charles C Thomas, Publisher, 1963. 8. Kahn, P., and Abrams, H. L.: Inferior Mesenteric Arterial Patterns , Radiology 82:429, 1964.Crossref 9. Laufman, H.; Nora, P. F.; and Mittelpunkt, A. I.: Mesenteric Blood Vessels: Advances in Surgery and Physiology , Arch Surg 88:1021, 1964.Crossref 10. McKain, J., and Shumacker, H. B., Jr.: Ischemia of Left Colon Associated With Abdominal Aortic Aneurysms and Their Treatment , Arch Surg 76:355, 1958.Crossref 11. Morris, G. C., Jr., and DeBakey, M. E.: Abdominal Angina, Diagnosis and Treatment , JAMA 176:91, 1961.Crossref 12. Moskowitz, M.; Zimmerman, H.; and Felson, B.: Meandering Mesenteric Artery of Colon , Amer J Roentgen 92:1088, 1964. 13. Nanson, E. M.: Vascular Lesions Producing "Acute Abdomen," Surg Clin N Amer 40:1241, 1960. 14. Shaw, R. S.: Vascular Lesions of Gastrointestinal Tract , Surg Clin N Amer 39:1253, 1959. 15. Zuidema, G. D., et al: Superior Mesenteric Artery Embolectomy , Ann Surg 159:548, 1964.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Apr 1, 1965

References