Surgical Management of Superior Mesenteric Arterial Emboli

Abstract

Since 1951, an aggressive surgical approach has shown promise in the treatment of embolic occlusion of the superior mesenteric artery. Klass^1,2 reported 2 such cases of embolization with successful embolectomy performed at 14 and 12 hours, respectively. Viable bowel resulted in both cases, but death resulted from cardiac failure in one patient and from postoperative hemorrhage in the other. A third case cited by Klass was a patient of Dr. Edward K. Connors, of Omaha, Neb. His patient died of pulmonary edema 48 hours after successful embolectomy. In 1957, Shaw and Rutledge³ reported a case in which superior mesenteric embolectomy was successfully performed 25 hours after embolization. No note is made of the exact location of the embolus, except that it lay in the main trunk of the superior mesenteric artery. Although all bowel encountered was grossly viable, the patient showed evidence of severe malabsorption and hypoproteinemic edema