PERIOPERATIVE INTRAARTERIELLE SPULPERFUSION ZUR ADJUVANTEN THERAPIE AKUTER INTESTINALER DURCHBLUTUNGSSTORUNGEN

The extent of mesenteric infarctions caused by intestinal circulation disorders essentially depends on reactive vasoconstriction and oxygen radical induced lesions of enteric mucosa. Animal experiments indicated protective effects of an intraarterial flushing perfusion of mesenteric arteries with vasodilators and anti-oxidants. We carried out a transaortic perfusion of the superior mesenteric artery with lactated Ringer's-solution and vasodilators (papaverin, tolazolin, PGE1) in acute occlusion of mesenteric arteries in 12 patients (case reports). Three patients were treated successfully without reconstruction by conservative method alone. Only one patient (8.33%) died because of uncontrolled enteric ischemia. Angiological therapy is necessary in modern treatment of acute mesenteric ischemia. Surgical goals are elimination of central vascular occlusions and resection of necrobiotic areas of intestinal organs.