Management of intestinal ischemia cases

In this study, 86 cases (46 male and 40 female) of intestinal ischemia,treated in the lası 10 years were eva­ luated retrospectively. The average age of whom was b'-3 (14 -80 ). The main clinical finding s were: general ab­ dominal tenderness in 100 %, distention in 66.3 % tachyarythmiain 51.2 % and rebound tenderness in 50 %. The average period between the onset of symptoms and presentatiton to the clinical was 72 hours. During sur­ gery, 60 cases (69.8 %) were determined as mesenteric artery embolism, 12 cases (14 %) as mesenteric artery thrombosis and 14 cases (16.2 %) as non-occlusive mesenteric ischemia (NOMI) cases of were superior mesen­ teric artery and inferior mesenteric artery thrombosis and 3 were celiac and superior mesenteric artery thrombo­ sis. 18 cases (20.9 %) required second-look. The mortality rate was 88.3 %. 6.9 % of the cases died peroperati­ vely, 46.5 % during the first two postoperative days, 22.1 % between 2nd and 1O th days and 12.8 % after the 10th day. Only 11.7 % of the cases could be discharged. Lale diagnosis was the major cause tor !his high mor­ tality rate. in our country, this can be related to the misdiagnosis of the doctors taking care of the initial evaluati­ on and the !ate referral of patient to the surgeon. Other reasons are: our obligatio n to perform wide resections in halt of the cases, lack of routine angiography in the initial evaluation, lack of intra-arterial pa paverin use and im­ proper digital consumption.