Prognosis of 20 Cases of Superior Mesenteric Artery Occlusion

Abstract

Superior mesenteric artery occlusion (SMA occlusion) is an uncommonly encountered abdominal emergency. We examined the data of 20 cases of SMA occlusion seen at our department between 1995 and 2012. The average age of the patients was 77 years (12 men, 8 women). Of the 20 patients, 19 (95%) had a past history of cardiovascular disease, and in 16 (80%), the diagnosis of SMA occlusion was made before the treatment. In regard to treatment, 16 patients underwent surgery, while 4 received thrombolytic therapy；1 patient required surgery after the thrombolytic therapy because of necrosis of the remaining bowel. There were 9 cases of in-hospital death (mortality rate：45%), including of 8 patients who had undergone surgery (mortality rate：50%), and 1 patient who had undergone thrombolytic therapy (mortality rate：25%). Second-look surgery was performed in 7 patients, of whom 2 required additional bowel resection and 1 died. On the other hand, in the 9 patients in whom no second-look surgery was performed, the mortality rate was high (78%) as compared to the group in which it was performed. In order to improve the prognosis of SMA occlusion, it is important to ensure that a second-look surgery is performed.