Ischémie střeva jako vážný problém chirurga

Intestinal Ischemia Represents Serious Surgical Problem

Surgeon rarely meets intestinal ischemia; it occurs in about 1 to 4 % of abdominal operations. At our clinic about 170 patients per year are operated with the mortality 55 to 85 %. It appears to be due to the advanced age of the treated patients, co morbidity and the late diagnosis. Intestinal ischemia can be caused by mesenteric arterial embolism (40 %), thrombosis developing upon an atherosclerotic plaque (30 %), nonocclusive form after the pharmacological treatment (20 %), post operation changes, circulatory failure during cardiac arrhythmias, reperfusion act. If the case is not diagnosed in time on the basis of the patient’s history and after the blood vessel examination, timely treatment cannot be done and the disorder can develop into the sepsis caused by intestinal perforation or in the more favourable circumstances by an extensive resection with the necessity to cooperate with an immunologist and nutritionist. Statistical data from the last years remain stable. To change the situation would require not only a development of invasive angiography but namely education of the medical doctors of the first and second line. 

Key words:
intestinal ischemia, nutrition, immunity.