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KMID : 0357019920080010122
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Journal of the Korean Vascular Surgery Society
1992 Volume.8 No. 1 p.122 ~ p.131
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Clinical Analysis of Superior Mesenteric Infarction
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Park Ho-Chul
Joo Hoong-Zae
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Abstract
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We performed a clinical analysis of 13 cases of superior mesenteric infarction, who were surgically managed at the Department of Surgery, Kyung Hee University Hospital from January, 1984 to December, l986.
The results were as follows,
1) The age of peak incidence was 7th & 8th decades and male to female ratio was 1.2: l.
2) The etiologies of superior mesenteric infarction were mesenteric artery embolism in 4 cases(31%), non-obstructive mesenteric infarction in 4 cases(31%), mesenteric artery thrombosis in 3 cases(23%) and mesenteric vein thrombosis in 2 cases(l5%).
3) The associated diseases were atrial fibrillation in 6 cases(46%), diabetes mellitus in 2 cases (15%), septic shock in 2 cases(15%), myocardial infarction in 1 case(8%), atherosclerosis in l case (8%) and unknown in 1 case(8%).
4) The most common symptom was abdominal pain and others were vomiting, nausea, and bleeding, cold sweating in the decreasing order of frequeney. And peritoneal irritation signs were examined in all patients except one whe was in the stuporous mentality and couldnt be checked for the sign.
5) The laboratory findings showed leukocytosis() 15,000/mm’) in 7 among 13 cases(54%), metabolic acidosis in 4 among 12 cases(33%) elevated hematocrit in 4 among 13 cases(31%), elevated amylase in 4 among 6 cases(67%), elevated LDH in 4 among 4 cases(100%) and elevated GOT in 4 among 8 cases(50%).
6) The mesenteric angiography was performed in 2 cases and their findings were well matched with postoperative diagnosis. But the preoperative sonographic findings in other two cases were unhelpful.
7) Bowel resection was performed in l0 cases, embolectomy in I case, thrombectomy followed by second look operation with near total small bowel resection in one case and open and closure in one case.
8) The most common postoperative complications were wound infection and diarrhea in 4 cases respectively.
9) The postoperative mortality was 62%.
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KEYWORD
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