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Surgical Technique |

Management of Acute Mesenteric Ischemia

M. Ashraf Mansour, MD
Arch Surg. 1999;134(3):328-330. doi:10.1001/archsurg.134.3.328.
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Acute mesenteric ischemia is a serious illness requiring prompt surgical attention. The clinical presentation, diagnostic strategy, and management of this disease are reviewed. Options for revascularization are briefly outlined.

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Figure 1.

The location of the superior mesenteric artery in relation to the fourth portion of the duodenum. The celiac axis can be approached through the gastrohepatic ligament and by exposing the crus of the diaphragm.

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Figure 2.

A transverse arteriotomy is used to insert the No. 3 or No. 4 Fogarty balloon catheter for embolectomy.

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Figure 3.

A retrograde iliac to superior mesenteric artery bypass is made with externally supported polytef (polytetrafluoroethylene).

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Figure 4.

An antegrade aorta to celiac artery and the superior mesenteric artery–bifurcated Dacron graft for severe stenosis of both the celiac and superior mesenteric arteries.

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