SOME ASPECTS OF TREATMENT OF PATIENTS WITH ACUTE MESENTERIC ISCHEMIA COMPLICATED BY BOWEL NECROSIS AND PERITONITIS

Acute mesenteric ischemia is a life-threatening disease requiring early diagnosis and surgical intervention to adequately restore mesenteric blood flow and prevent bowel necrosis and patient death. Despite advances in understanding the pathogenesis of mesenteric ischemia and the development of modern treatment methods, acute mesenteric ischemia remains diagnostically challenging for experienced doctors, and a delay in diagnosis contributes to high mortality. To improve the clinical outcome, early diagnosis and rapid efficient treatment are required. The paper analyzes the results of treatment of 163 patients with acute mesenteric ischemia with decompensation of blood flow at the stage of intestine necrosis and peritonitis. The age of patients was (74.70 ± 12.27). 92% of patients had severe cardiovascular pathology related to arrhythmias. The onset-to-door time (time from onset of the first symptoms to hospitalization) was three days. All the patients underwent bowel resection, in 121 cases (74.2%) with application of primary intestinal anastomosis. In 42 cases, the obstructive resection with application of delayed anastomosis was performed. In the first group, the leak occurred in 68 cases, while in the second group it occurred in 4 cases. Obstructive bowel resection with programmed relaparotomy is a promising method of surgical treatment of patients with acute mesenterial thrombosis complicated by intestine necrosis and peritonitis.

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