Abstract
Four operated cases of ischemic lesion of the small intestine are described. The average age was 73-year-old. There were each two males and females. All patients presented with intestinal obstruction with panperitonitis. Two patients had hypertension and cerebral infarction and one had diabetes as underlying disease. It took about 38 hours on average from the onset of symptoms to the operation. The lesions were found in the jejunum to ileum in 2 cases and in the ileum in another 2 cases.
Operative procedure included extended small intestianl resection in 2 cases; partial resection of the ileum including necrotic lesions in one and explorately laparotomy in the remaining one because no obvious necrotic lesion appeared. Histologically, 2 cases had ischemic necrosis of the small intestine caused by thrombosis of the superior mesenteric vein and the other case causing by sclerosis of the superior mesenteric artery. Two out of the 4 cases died.
It was supposed that high risk group in this disease might be aged people more than 80 years old with venous complications, such as hypertension, cerebral infarction and diabetes mellitus, and probable causes of this disease might be postoperative reobstruction and recurrent necrosis. Administration of ulinastatin was effective in the prevention of postoperative acute circulating injury, liver and renal dysfunction, and DIC.
