Second Look Surgery for Acute Superior Mesenteric Artery Embolisms

DOI 3 Citations 8 References
  • Oono Ryo
    Department of Surgery, Niigata Prefectural Toukamachi Hospital
  • Hayashi Mikiko
    Department of Surgery, Niigata Prefectural Toukamachi Hospital
  • Shitara Kenji
    Department of Surgery, Niigata Prefectural Toukamachi Hospital
  • Ookawa Takuya
    Department of Surgery, Niigata Prefectural Toukamachi Hospital
  • Iseki Hideaki
    Department of Surgery, Niigata Prefectural Toukamachi Hospital
  • Fukunari Hiroyuki
    Department of Surgery, Niigata Prefectural Toukamachi Hospital
  • Ishida Takao
    Department of Surgery, Nakano General Hospital

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Other Title
  • 血栓除去手術後2nd look surgeryにて腸管大量切除を行い救命し得た上腸間膜動脈塞栓症の1例

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Abstract

A 78-year-old man with atrial fibrillation underwent a sigmoidectomy because of an adenoma with severe atypia. Abdominal pain developed on 9th postoperative day. Contrast enhanced CT scan of the abdomen showed thrombosis of the superior mesenteric artery. Angiography showed a replaced right hepatic artery and the thrombosis of the superior mesenteric artery. Despite infusion of urokinase in the superior mesenteric artery, the blood supply did not recover. A thrombonectomy was performed with successful revascularization. Twelve hours later second look surgery was performed. In the small intestine, 80cm from the Treitz' ligament to the ascending colon was necrotic, so we excised the necrotic lesion and created a double-ostomy without post-operative complications. Second look surgery is an effective surgical treatment following thrombectomy for thromboses of the superior mesenteric artery.

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