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Wednesday, March 9, 2011

ACUTE INTESTINAL FAILURE

This term describes the consequences of acute obstruction of the superior mesentric artery.
 A variable length of the small intestine undergoes necrosis of the superficial epithelium and over several hours this progresses to gangrene. There may be a prodromal period of episodic or chronic abdominal pain often related to meals. This progresses to more severe abdominal pain, vomitting, watery and later bloody diarrhoea. Signs of peritonitis and hypovolaemic shock develop.

The diagnosis is essentially clinical but is assisted by the finding of a leucocytosis of up to 20,000-30,000/mm3. The findings on a plain abdominal radiograph are usually non- specific. Arteriography may be used to confirm the diagnosis provided it does not delay the urgent vascular surgery necessary to prevent gangrene. Unfortunately extensive resection of the small intestine is necessary in many patients and the overall mortality is 50%.

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