| 摘要 |
From October 1990 to March 1996, 34 patients with acute mesenteric ischemia were treated at the Veterans General Hospital-Kaohsiung. Among them were 29 males and 5 females whose mean age was 71 years, with a range of 42-88 years. Except for one case diagnosed by angiography, the dia-gnosis was verified in all cases by laparotomy. The risk factors included old age in with previous heart disease, symptoms of peripheral atherosclerosis, portal hypertension, and experience of hypotension before s abdominal discomfort. Presenting clinical features consisted of abdominal pain (74 percent), peritonitis (62 percent), shock (56 percent), and metabolic acidosis (53 percent). The disease was diagnosed by angiography in one patient, who recovered without surgical intervention. The other 33 patients were treated surgically: Seven underwent exploratory laparotomy, 25 underwent bowel resection, and 1 underwent revascularization. The overall mortality was 74%. Patients with preoperative shock or acidosis had a poor prognosis. Earlier diagnosis by more widespread use of emergency angiography, coupled by revascularization procedures should offer the best chance for future improvement. |
