| Theme | Gastrointestinal Disease Due to Blood Flow Damage | |
|---|---|---|
| Title | Superior Mesenteric Artery Embolic Obstruction/Thrombotic Obstruction | |
| Publish Date | 2019/01 | |
| Author | Tetsuya Takahashi | Department of Emergency and Critical Care Medicine, Yokohama City Minato Red Cross Hospital |
| Author | Yusuke Nakayama | Department of Emergency and Critical Care Medicine, Yokohama City Minato Red Cross Hospital |
| Author | Tetsuhiro Takei | Department of Emergency and Critical Care Medicine, Yokohama City Minato Red Cross Hospital |
| [ Summary ] | Superior mesenteric artery (SMA) embolic and thrombotic obstruction (SMA occlusion) is one of the most important conditions in the acute abdomen because intestinal infarction is caused by a long period of time elapsed, despite the difficulty of early diagnosis. Treatment with interventional radiology (IR) is indicated for SMA occlusion in cases of intestinal ischemia, and intestinal resection needs to be performed in patients who develop intestinal infarction. Assessing the viability of the intestines is difficult; however, IR is useful to treat SMA occlusion if the patient does not present with obvious signs of intestinal infarction. The viability of the intestines in patients presenting with SMA occlusion depends upon the development of adequate collateral circulation. Thus, the time interval from the onset is important. The possibility of intestinal necrosis should be considered in patients in whom angiography shows inadequate collateral circulation with poor visualization of collaterals, notwithstanding the restoration of blood flow into the SMA stem and its branches via IR. | |