Results of 14 Cases of Superior Mesenteric Artery Occlusion

Abstract

Superior mesenteric artery (SMA) occlusion is rare, and the treatment results have not yet become favorable. The survival rate of SMA occlusion has improved due to the improvement of diagnostic and treatment techniques, but the mid- and long-term prognosis due to postoperative short bowel syndrome is still poor. The treatment options for SMA occlusion are surgery and intervention, but it is not clear which offers the greatest advantage. We examined the treatment strategies for SMA occlusion, and examined 14 cases that were managed in our hospital from 2012 to 2018. We conducted trial laparotomies in 8 cases (5 cases of thrombectomy and 3 cases of intestinal resection). At the time of thrombectomy, 2 patients underwent resection. Of the 5 patients who underwent percutaneous endovascular therapy (IVR), 2 patients did not undergo enterectomy. The survival rate was 86%. Massive enterectomy could be avoided in revascularized cases. It may be possible to avoid massive enterectomy by performing IVR or open thrombectomy, and it is thought that second-look surgery for the evaluation of delayed enteric ischemia after revascularization is beneficial.