[Experience in the management of acute superior mesenteric artery ischemia].

OBJECTIVE: To study the management of acute superior mesenteric artery (SMA) ischemia and to improve its prognosis. METHOD: The clinical data of 37 patients treated from January 1996 to August 2007 was retrospectively reviewed. RESULTS: Of the cases, 19 (51.4%) patients were diagnosed with acute SMA embolism, 15 (40.5%) with acute SMA thrombosis, 2 (5.4%) with spontaneous isolated dissection of SMA and 1 (2.7%) with SMA aneurysm. Nineteen (51.4%) patients were misdiagnosed in emergency. Eighteen (48.6%) patients died in the hospital, and most of them died of severe infection and multiple organ failure. Three cases of the survived 19 patients experienced severe complications (2 with short gut syndrome, 1 with cerebral hemorrhage). Nine cases were followed-up for a mean period of 15 months, and 5 died during that term. CONCLUSIONS: Acute SMA ischemia has multiple etiological factors. Early intervention can improve the prognosis.