Acute abdomen: superior mesenteric artery occlusion - 23/08/11
Doi : 10.1016/j.gie.2008.04.036
| Commentary It recently has been shown that isolated right colon ischemia (IRCI) has a worse prognosis than does ischemia involving any other segment of the colon: patients with IRCI require surgery 5 times more frequently and have a mortality rate that is twice that of patients with non-IRCI. Presentation of IRCI also may differ from that of non-IRCI, with abdominal pain being more frequent than hematochezia. The importance of recognizing IRCI is, as in this case, that it may be the heralding presentation of an otherwise silent SMA occlusion, which, if not diagnosed and corrected promptly, will have a mortality rate approaching 100%. The sudden onset of mid-abdominal pain, especially when followed by an explosive bowel movement, is the classic presentation of an SMA embolus. The major thing healthcare providers can do to reduce the staggering mortality of acute mesenteric ischemia, and also IRCI, is to diagnose the condition early and treat it definitively. For these providers, congratulations on a job well done! Lawrence J. Brandt, MD Associate Editor for Focal Points |
© 2008
American Society for Gastrointestinal Endoscopy. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 68 - N° 5
P. 1001-1002 - novembre 2008 Retour au numéro
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