Early diagnosis and surgical treatment of acute superior mesenteric artery occlusion.

Objective: To investigate the value of early diagnosis and the effect of surgical treatment of acute superior mesenteric artery occlusion.

Methods: Forty-eight patients underwent superior mesenteric artery embolectomy. The diagnosis was made by mesenteric angiography in 12 patients, by explorative laparotomy in 15 patients and by abdominal contrast-enhanced CT in 21 patients. The patients were divided into three groups according to the onset of symptoms and operation time. Patients in group I (n = 15) were operated on in the first 6 hours after onset of symptoms; Patients in group II (n = 19) were operated on between 6 and 12 hours after onset; and patients in group III (n = 14) underwent embolectomy after 12 hours.

Results: The macroscopic view of the intestine was normal in 24 patients (15 in group I and 9 in group II) 30 minutes after embolectomy and administration of urokinase. Segmental resection was necessary in 8 patients in group II. Extended resection was necessary in 2 patients in group II and 14 patients in group III, and all of the patients died during the early postoperative period.

Conclusions: Early diagnosis and prompt surgical treatment can reduce the incident of bowel necrosis and mortality rate of patients with superior mesenteric artery occlusion.