Acute occlusion of mesenteric vessels
Acute occlusion of mesenteric vessels. Causes: embolism, thrombosis, exfoliating aneurysm of the abdominal aorta, trauma. Necrosis of the intestine can also occur with a decrease in cardiac output below the critical level without occlusion of mesenteric vessels. In 90% of cases occlusion of the superior mesenteric artery occurs, in 10% of the lower. With thrombosis, the occlusion of the main trunk of the superior mesenteric artery often occurs, which is complicated by necrosis of the entire small and large intestine to the splenic angle. With embolism, an occlusion of the more distal parts of the vessel occurs, while the necrosis zone is smaller.
Symptoms, course. The clinical picture of the disease depends on the time that has elapsed since its inception. There are 3 stages: I - the initial stage. In the clinical picture, a triad of symptoms prevails: abdominal pain, shock and diarrhea. Characteristic is the discrepancy between the severe general condition of the patient and the relatively small changes detected during examination of the abdomen: bloating and moderate soreness without symptoms of irritation of the peritoneum. When auscultation - weakening intestinal peristalsis. The picture of the blood is not changed. Radiologic examination determines the pneumatization and thickening of the wall of the small intestine. The duration of the stage is 1-6 hours. Stage II (7-12 hours): severe pain in the abdomen, palpation shows an increase in soreness, but there are no peritoneal symptoms, the patient's condition gradually worsens. With finger examination of the rectum there may be bloody discharge. In the blood-the growth of leukocytosis, the radiographic changes are the same; Lit stage - stage of bowel necrosis (after 12 hours). Symptomatics of diffuse peritonitis and paralytic intestinal obstruction, in the blood - high leukocytosis, with radiographic examination of the abdominal cavity - multiple levels of fluid.
Diagnosis is based on history, search for a source of embolism (ciliary arrhythmia, rheumatic heart disease), clinical manifestations of shock, intestinal paresis. An angiographic study is desirable. Later, surgical intervention causes the development of severe complications. In the third stage of the disease, arterial occlusion is associated with mesenteric venous thrombosis.
Treatment is only prompt. In the first stage, intestinal revascularization is performed by removing thrombus or thrombinectomy; In the II stage, in the presence of focal necrosis of the intestinal wall, revascularization is supplemented with intestinal resection; In the Ill stage-only massive bowel resection can save the patient's life. As a rule, operative BMD is performed in stages II-III of the disease; The postoperative lethality is 90%.
- Surgical diseases
- Abscess
- Abscess appendicular
- Abscesses of the abdominal cavity
- Abscess of the Douglas space
- Intestinal abscess
- Abscess of the lung
- Soft tissue abscess
- Abscesses of soft tissues after injection
- Abscess of liver
- Amoebic liver abscess
- Prostate adenoma
- Actinomycosis
- Aneurysm
- False aneurysm
- True aneurysms
- Aneurysm of the aortic arch
- Aneurysm of descending thoracic aorta
- Dissecting Aneurysm
- Aneurysm of the abdominal aorta
- Aneurysm of peripheral vessels
- Arteriovenous aneurysm
- Aneurimas of the heart
- Appendicitis acute
- Perforation of the appendage
- Appendicular infiltration
- Pielephlebitis
- Atheroma
- Bronchoectasis
- Varicose veins
- Varicose veins of the spermatic cord
- Dropsy of testis and spermatic cord
- Rectal prolapse
- Gangrene gas
- Gangrene lung
- Hemorrhoids
- Hydradenite
- Gynecomastia
- Hernia
- Internal hernias
- Hernias of the esophagus
- External hernias
- Herniated hernias
- Herniated hernia
- Hernia of the white line
- Hernia postoperative ventral
- Herniated hernia
- Rare hernias
- Pincushion
- Phlegmon hernial sac
- False infringement of a hernia
- Hernias with inflammation
- Dumping syndrome
- Diverticulum
- Esophagus diverticulum
- Cervical diverticulum
- Bifurcation diverticulum
- Epiphrenial diverticulum
- Epiphrenial diverticulum
- Diverticulum of the stomach
- Diverticulum of the duodenum
- Meckel's diverticulum
- Jaundice mechanical
- Bile duct stones
- Ventilated stone of choledoch
- Papillotenosis
- Stricture of bile ducts
- Cancer of the head of the pancreas
- Cholelithiasis
- Urinary retention acute
- Zollinger-Ellison syndrome
- Foreign bodies of bronchi
- Foreign bodies of the stomach
- Foreign bodies of the esophagus
- Foreign bodies of soft tissues
- Carbuncle
- Brushes and fistulas of the neck are lateral
- Cysts and fistulas of the neck median
- Colitis ulcerative ulcerative
- Coccygeal epithelial passage
- Cryptorchidism
- Bleeding
- Bleeding internal
- Bleeding gastrointestinal
- Varicose veins
- The Mallory-Weiss Syndrome
- Bleeding into the abdominal cavity
- Bleeding pulmonary
- Bleeding external
- Parenchymal hemorrhage
- Crohn's disease
- Lymphadenitis
- Lymphangitis
- Mastitis
- Putrefactive mastitis
- Acute non-lactational mastitis
- Chronic mastitis
- Megacolon
- Mediastinitis
- Intestinal obstruction
- Paralytic intestinal obstruction
- Mechanical intestinal obstruction
- X-ray diagnostics
- Specific types of intestinal obstruction
- Ingrown throat
- Frostbite
- Local cooling
- Burn
- Occlusion of the main arteries
- Acute occlusion of the vessels of the extremities
- Chronic occlusions of arterial vessels
- Obtiterating atherosclerosis
- Aortic ileal type
- Hips and popliteal type
- Peripheral type
- Occlusion of aortic arch branches
- Occlusion of carotid arteries
- Occlusion of the subclavian artery
- Takayasu's syndrome (absence of pulse)
- Chronic occlusion of mesenteric vessels (abdominal toad)
- Stenosis of the renal arteries
- Obliterating thrombangitis
- Raynaud's disease
- Orcoepididymitis
- Acute abdomen
- Acute pancreatitis
- Chronic pancreatitis
- Acute cholecystitis
- Panaritium
- Panaritium cutaneous
- Paronichy
- Panaritium subungual
- Panaritium tendinous
- Panaritium articular
- Panaritium bone
- Penetrating ulcer of the stomach and duodenum
- Peritonitis
- Peritonitis chronic
- Piopevneumotorax
- Pneumothorax is spontaneous
- Postcholecystectomy syndrome
- Perforated ulcer
- Covered perforation
- Bedsore
- Prostatitis
- Wounds
- Fistulas of the rectum
- Stenosis of the outlet stomach
- Fracture of anus
- Urethritis
- Phimosis, paraphimosis
- Phlebothrombosis
- Occlusion of subclavian vein
- Phlegmon
- Furuncle
- Cholangitis
- Electric trauma
- Empyema of the pleura
- Congenital intestinal obstruction
- Atresia of the anus
- Congenital cholangiopathy of newborns
- Pylorostenosis
- Embryonic hernia (hernia of umbilical cord)
- Exstrophy of the bladder
- Dropsy of shells of testis and spermatic cord
- Surgical diseases of the chest
- Congenital diaphragmatic hernia
- Congenital cysts of the lungs
- Pneumothorax
- Tracheophishoprine fistula
- Mastitis of newborns
- Acute hematogenous osteomyelitis
- Peritonitis in newborns
- Acute paraproctitis
- Necrotic phlegmon of newborns
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