Aortoiliac Steal Syndrome and Necrosis of Gastrointestinal Tract

Abstract

IN 1965 Kountz et al¹ pointed out that redistribution of blood flow from the mesenteric to the peripheral vascular bed might be the causal factor in some cases of mesenteric ischemia. They presented a patient who developed patchy infarction of the small bowel following sequential sympathectomy and right ileofemoral bypass. In subsequent animal experiments they showed that cross-clamping of the aorta resulted in a modest increase in flow in the superior mesenteric artery. Release of the aortic clamp caused a decrease in blood flow below the preocclusion flow levels in the superior mesenteric. Although necrosis of the gut has been observed following extensive vascular surgery, all reported cases have occurred with division of the inferior mesenteric artery which may be the major source of intestinal blood flow. We would like to report an experience that supports the theory of redistribution of blood flow without the presence of a sympathectomy.