February 1967

Aortoiliac Steal Syndrome and Necrosis of Gastrointestinal Tract

Author Affiliations

Morgantown, WVa
From the Department of Surgery, Veterans Administration Hospital, Clarksburg, WVa, and West Virginia University Medical Center, Morgantown.

Arch Surg. 1967;94(2):172-174. doi:10.1001/archsurg.1967.01330080010003

IN 1965 Kountz et al1 pointed out that redistribution of blood flow from the mesenteric to the peripheral vascular bed might be the causal factor in some cases of mesenteric ischemia. They presented a patient who developed patchy infarction of the small bowel following sequential sympathectomy and right ileofemoral bypass. In subsequent animal experiments they showed that cross-clamping of the aorta resulted in a modest increase in flow in the superior mesenteric artery. Release of the aortic clamp caused a decrease in blood flow below the preocclusion flow levels in the superior mesenteric.

Although necrosis of the gut has been observed following extensive vascular surgery, all reported cases have occurred with division of the inferior mesenteric artery which may be the major source of intestinal blood flow.

We would like to report an experience that supports the theory of redistribution of blood flow without the presence of a sympathectomy.

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