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  • Title: [Intestinal ischemia after abdominal aorta surgery. A dreaded complication surveyed by a combination of different methods].
    Author: Björck M, Bergqvist D, Troëng T, Haglund U, Hedberg B.
    Journal: Lakartidningen; 1999 Sep 01; 96(35):3659-62. PubMed ID: 10492572.
    Abstract:
    The article consists of a review of findings in previously published reports on intestinal ischaemia after abdominal aortic surgery. In a combined cohort and case-control study of 2,824 patients from the Swedish vascular registry, the incidence of intestinal ischaemia was 2.8%. The independent risk factors identified were preoperative shock, emergency surgery, renal insufficiency, advanced age, operation at a regional hospital, aortabifemoral grafting, ligation of one or both internal iliac arteries, bleeding > 10 litres, and operating and cross-clamping time. Cardinal symptoms were unreliable predictors. Sigmoidoscopy was potentially diagnostic in 95 per cent of cases. In a clinical study of 34 patients, sigmoid colon pHi was highly predictive of ischaemic colitis and other life-threatening complications. In a por-cine model of ischaemic colitis, blood flow in the superior mesenteric artery, colonic pHi and histological mucosal damage were unaffected by dobutamine.
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