Document Detail


Prognostic factors in extensive mesenteric ischaemia.
MedLine Citation:
PMID:  3415165     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The records of 65 patients with diagnoses of extensive intestinal ischaemia during the 10 years from December 1973 to January 1984 were retrieved from 18 hospitals in Ireland. There were 32 males and 33 females, ranging in age from 20 to 96 years (mean 69.8 years). Duration of symptoms ranged from 4 h to 8 days. Pain was the most common presenting feature. Gastrointestinal haemorrhage was apparent in 31%, hypotension in 28% and atrial fibrillation in 43%. Associated vascular disease was present in 43%. There were elevations of serum inorganic phosphate in 15%, leucoytosis in 65% and metabolic acidosis in 67%. The mean interval from hospital admission to operation in survivors was 14.5 h, whereas the mean delay in those who died was 44 h. The correct preoperative diagnosis was made in 23 (35%) and the aetiology of intestinal ischaemia was recorded as: thrombosis 25 (39%), embolism 12 (18%), adhesions/volvulus 4 (6%) and indeterminate in 24 (37%). Laparotomy was performed in 49: gangrenous bowel was resected in 29 and six had operations designed to revascularise the intestine. The remaining 14 patients either had laparotomy alone (12) or an inappropriate operation (2). In 46 patients (70.8%) who died, death was related to three factors: the mean age of survivors was 7 years less than that of patients who died, the interval to laparotomy was on average 30 h less, and the length of ischaemic bowel was on average 61% less.
Authors:
T F Gorey; M O'Sullivan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the Royal College of Surgeons of England     Volume:  70     ISSN:  0035-8843     ISO Abbreviation:  Ann R Coll Surg Engl     Publication Date:  1988 Jul 
Date Detail:
Created Date:  1988-09-23     Completed Date:  1988-09-23     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7506860     Medline TA:  Ann R Coll Surg Engl     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  191-4     Citation Subset:  IM    
Affiliation:
Department of Surgery, Royal College of Surgeons, Dublin, Ireland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Female
Humans
Infarction / etiology
Intestines / blood supply,  surgery
Male
Mesenteric Arteries
Mesenteric Vascular Occlusion / complications,  diagnosis,  surgery*
Mesenteric Veins
Middle Aged
Prognosis
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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