Abstract
(Purpose) Superior mesenteric artery (SMA) embolisms are rare, and the treatment results to date have not been favorable. The treatment options for SMA embolisms are surgery and intervention, but it is not clear which offers the greatest advantage. We examined these treatment choices in patients with SMA embolisms. (Subjects and Methods) The subjects were 22 SMA embolism patients in our hospital between April 2001 and April 2010. Twelve patients underwent operations, 4 patients were treated by intervention, 2 patients received heparinization, and 4 patients received no treatment. We compared the operation group (Op group) with the intervention group (Iv group) for survival rate, laboratory data (white blood cell count, CRP, CPK, LDH, ALP, and BE), perioperative computed tomography findings (intestinal emphysema, ascites, and enlargement of intestine), and the time from onset. (Results) The survival rate was 75% (9/12) in the Op group and 100% (4/4) in the Iv group. In laboratory data, there was a significant difference only in CRP (Op group: Iv group=9.3±10.2: 0.4±0.5, p<0.05). In computed tomography findings, there was a significant difference only in enlargement of the intestine (p<0.05). Intestinal emphysema was recognized in 3 patients in the Op group only. The time from onset in the Iv group was shorter than in the Op group (Op group: Iv group=24±19hr: 9±3hr, p<0.05). (Conclusion) A strategy for the treatment of superior mesenteric artery embolisms should be decided considering CRP in the laboratory data, enlargement of the intestine and intestinal emphysema on computed tomography, and the time from onset.
