The Diagnosis And Treatment Of Ischemic Bowel Disease, Experience In42Cases

Objective: To improve the cognition of ischemic bowel disease.Methods: To analyze, with the literature, the42cases of ischemic bowel diseasetreated in General Surgery of Dalian Medical University Second Affiliated Hospitalfrom July2003to November2011, we make a retrospective analysis about theassociated Underlying diseases, clinical symptoms, laboratory examinations results, andtreatment of ischemic bowel disease.Results: In42cases, abdominal pain as the first symptom in30cases,accompanied by nausea and vomiting in21cases, in which8cases is accompanied bythe symptoms of gastrointestinal obstruction. In30cases which was abdominal pain asthe first symptom, accompanied by hemafecia in9cases.42cases underwent abdominalDoppler ultrasound examination,42cases underwent abdominal CT examination,1case underwent abdominal enhanced CT examination,22cases underwent routine X-rayabdomen supine and standing plain film examination,19cases underwent CTA scan,17underwent ECG examination, and13cases underwent colonoscopy. The17casesunderwent operation therapy, including1case with family members give up to continuethe treatment and require discharge,1case of death.1case of interventional therapy,postoperative recovery was good.24cases received conservative treatment,1case dueto family members give up to continue treatment and require discharge,1cases ofdeath.Conclusions:1. Acute severe abdominal pain, intense gastrointestinal emptying symptoms and ahistory of previous organic systemic vascular obstruction triad can be used as theguiding standard of diagnosis of ischemic bowel disease.2. CTA can be used to early diagnose ischemic bowel disease, and has a high clinical value.3. During the operation, intraoperative Doppler ultra-sound and intravenousfluorescein can be applied for help judging the vitality of residual intestine.