상부장간막 동맥색전증 = Superior Mesenteric Artery Embolism

다국어 초록 (Multilingual Abstract)

Superior mesenteric artery (SMA) embolism is a catastrophic and most impressive event in surgical field. Due to its diagnostic difficulty and delay, the mortality is still up to 85%. Fourteen patients among sixteen cases experienced from September 1979 to september 1991 at Seoul National University Hospital Department of Surgery, were reviewed. The patients were between 33 and 82 years old and the number of male and female patients were eight and six, All patients had heart disease being to cause SMA embolism and clinical manifestations were abdominal pain, vomiting, diarrhea, bloody diarrhea, abdominal distention, shock, fever etc. The time relapse of onset to operation were from 6 hour 30 min. to 69 hours and the average was 34 hour 20 min. In eight cases, the angiography was performed for the diagnosis. The operation was performed in 12 patients, one patients was died before operation, and another delayed due to poor general condition, was alived after vasodilator and anticoagulant therapy. Resection and anastomosis only was performed in eight cases, resection and anastomosis after embolectomy in three cases, and embolectomy and second look operation in one case. Postoperative complications were mortaiity in three cases, diarrhea in all cases, pulmonary complication in six cases, wound infection in three cases, wound disruption in two cases, etc. The short bowel syndrome was presented in two cases. By comparison between mortality and survivor cases, the remained bowel length, eg. resection lenght of small bowel is the major factor of mortality and severe complicaitons. In conclusion, we should have more suspcion, aggressively approaching attitude and tools to obtain better prognosis and less complications.