Nonocclusive mesenteric infarction

Nonocclusive mesenteric infarction is a disease of increasing surgical significance. It is manifested by abdominal pain, usually occurring in a patient with known atherosclerotic heart disease. Over the course of days gastrointestinal bleeding, peritonitis, and finally shock develop. Shock is a late reflection of the disease and usually is not a precipitating factor. The hemorrhagic mucosal necrosis is seen in the absence of obstruction to the arterial system, at least to the 50 μ. level, and is seen in other than terminal conditions.The diagnosis can be suspected on clinical grounds and supported by arteriographic studies. The principles of therapy include massive fluid volume replacement, support of cardiac function, interruption of splanchnic vasoconstriction, and control of septicemia and endotoxemia.