Yunus NAZLI, Mikdat BOZER, Necmettin ÇOLAK, Kayıhan AKIN, İsmail Olgun AKKAYA, Hüseyin ŞAHİN, Ömer ÇAKIR

Surgical treatment of chronic mesenteric ischemia with splenic artery-to-superior mesenteric artery bypass: a case report

Kronik mezenterik iskemi, yüksek mortalite ve morbidite oranları ile karın ağrısının nadir, fakat önemli bir nedenidir. Yemek sonrası karın ağrısı, sitofobi ve kilo kaybı önemli klinik bulgu ve belirtilerdir. Tedavinin esas amacı, intestinal perfüzyonu yeniden sağlayarak hastanın belirtilerini ortadan kaldırmak ve bağırsak nekrozlarını önlemektir. Kronik mezenterik iskeminin tanısında Doppler ultrasonografi, bilgisayarlı tomografi anjiyografi, manyetik rezonans anjiyografi ve konvansiyonel anjiyografi kullanılır. Kronik mezenterik iskeminin tedavisinde medikal tedavinin yanı sıra cerrahi tedavi veya endovasküler girişimler de kullanılabilir. Bu yazıda inferior ve superior mezenterik arteri tıkalı kronik mezenterik iskemisi olan ve splenik arterden superior mezenterik artere baypas ameliyatı ile başarılı şekilde tedavi edilen 60 yaşında bir kadın olgu sunuldu.

Splenik arterden superior mezenterik artere baypas ile kronik mezenterik iskeminin cerrahi tedavisi: Olgu sunumu

Chronic mesenteric ischemia is a rare, but important cause of abdominal pain with high mortality and morbidity rates. Postprandial abdominal pain, sitophobia and weight loss are the important clinical signs and symptoms. The main goal of the treatment is to relieve patient’s symptoms by restoration of intestinal perfusion and to prevent intestinal necrosis. Doppler ultrasound, computed tomography angiography, magnetic resonance angiography and conventional angiography are used in the diagnosis of chronic mesenteric ischemia. Surgical or endovascular interventions as well as medical therapy may be used in the treatment of chronic mesenteric ischemia. In this article, we present a 60-year-old female case of chronic mesenteric ischemia with inferior and superior mesenteric artery occlusion, who was successfully treated with splenic arteryto- superior mesenteric artery bypass surgery.

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