CLINICAL SIGNIFICANCE OF ABDOMINAL ISCHEMIA SYNDROME

Aim. To determine the occurrence and detection rate of the most significant clinicoinstrumental signs of chronic abdominal ischemia in patients with acute mesenterial insufficiency. Materials and methods. The results of treatment of 165 patients with chronic abdominal ischemia and acute mesenterial insufficiency syndromes were analyzed. For the purpose of revealing the most significant symptoms of chronic abdominal ischemia which widen the opportunity of early diagnosis of acute mesenterial insufficiency, all patients were divided into two groups. The main group included 87 patients with the signs of chronic mesenterial insufficiency and ischemic visceropathies (ischemic gastropathy, hepatopathy, pancreatopathy, colopathy) confirmed by ultrasonic dopplerographic investigation of unpaired aorta branches. The comparison group consisted of 78 patients with different types of acute mesenterial insufficiency. During the study, comparative analysis of clinical and anamnestic data, results of laboratory, endoscopic and ultrasonic methods of investigation of internal organs and visceral vessels was carried out. Results. The most typical clinical, endoscopic and ultrasonic symptoms of chronic abdominal ischemia were detected; occurrence rate of these symptoms in patients with acute disturbance of visceral circulation was analyzed. The most significant clinical symptoms and morphological manifestations of chronic visceral insufficiency were determined that allows in case of acute abdominal pain syndrome to suspect pathology of unpaired abdominal aorta branches and to perform early diagnosis of acute mesenterial insufficiency. Correlation between the lethality, late diagnosis and waiting tactics of treatment was established. Optimal approaches used for early diagnosis of acute and decompensation of chronic mesenterial insufficiency were determined. Conclusion. Early diagnosis as well as laparotomy and revasculizing surgery on the mesenteric artery performed by both abdominal and vascular surgeon essentially improve prognosis of this disease.

Abdominal ischemia syndrome, acute mesenterial thrombosis