Surgical Outcomes in Cases of Acute Superior Mesenteric Artery Occlusion: A Report of Three Cases with a Review of the Literature

Abstract

We present reports of three patients with acute superior mesenteric artery occlusion (SMAO) who were treated by surgery, with a review of the literature. Case 1: A 74-year-old woman underwent extensive small bowel resection due to SMAO. The remnant intestinal segments were anastomosed (jejunum: 40 cm, ileum end: 10 cm). The postoperative course was uneventful and the patient is being followed up. Case 2: A 75-year-old man who was diagnosed as having SMAO underwent resection of the small bowel with a part of the ascending colon, followed by creation of an ileostomy and colostomy. The patient’s postoperative course was complicated by the development of catheter infection prior to discharge from the hospital. Thereafter, the patient was hospitalized a total of 7 times for urinary tract infection, renal dysfunction and sepsis, and died 807 days after surgery. Case 3: An 83-year-old man with SMAO underwent extensive small bowel resection followed by jejunostomy (remnant jejunum: 40 cm). The patient died 465 days after surgery, of infection of the central venous access device, pyogenic spondylitis and sepsis. Thus, favorable long-term outcomes would usually not be expected, even in patients rescued by extensive intestinal resection. Inclusive care, including fluid/nutrition management and infection control are indispensable for short bowel syndrome.