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A Journal on Surgery

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Chirurgia 2003 October-December;16(5-6):163-6

language: Italian

''Second-look'' in the surgical therapy of mesenteric infarction

Lotti R., Perri G., Nardi M. jr, Nicita A., Pietrangeli F., Dalla Torre A., Amendolara M., Gabbrielli F., Castiglia D., Moraldi A., Citone G.


Aim. Acute mesenteric ischemia is the result of inadequate blood flow to all or part of the small intestine and the right half of the colon. Mesenteric infarction is a pathology which is encountered fairly often in elderly patients where the concomitance of other diseases makes its prognosis more severe, especially since the diagnosis is usually late. Acute mesenteric ischemia presents a 60-85% mortality rate. The ''second-look'' operation in patients with doubtful viability of the intestine may reduce the extent of resection at primary exploration and also the incidence of insufficient anastomosis.
Methods. The authors report their experience about the ''second-look'' problem on the basis of 42 patients who underwent surgical operation for mesenteric infarction with 11 ''second-look'' operations. The median age of patients was 78 years (range 67-92). Overall mortality was 71% (30 patients out of 42).
Results. Mortality rate for ''second-look'' was 64% (7 patients), 4 survivors with a median hospital stay of 17 days (range 18-29).
Conclusion. The conclusion is drawn that the ''second-look'' operation could improve the outcome of patients with intestinal infarction.

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