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February 1979

Determination of Intestinal Viability by Doppler Ultrasound

Author Affiliations

From the Department of Surgery, East Orange (NJ) Veterans Administration Medical Center (Drs Hobson, O'Donnell, Jamil, and Najem); the Division of Vascular Surgery, College of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark (Drs Hobson, O'Donnell, Jamil, and Najem); the Department of Surgery, Iowa City VA Medical Center (Drs Wright and Lamberth); and the Division of Cardiovascular Surgery, University of Iowa School of Medicine, Iowa City (Drs Wright and Lamberth).

Arch Surg. 1979;114(2):165-168. doi:10.1001/archsurg.1979.01370260055008

• The Doppler ultrasonic flowmeter was used to determine intestinal serosal and mesenteric blood flows in 130 patients who underwent abdominal aortic vascular procedures and in 14 patients who underwent general surgical procedures. Temporary occlusion of the inferior mesenteric artery (IMA) during aortic surgery resulted in the absence or marked diminution of collateral blood flow over the left side of the colon in eight patients. One patient had the flow in the IMA preserved by proper placement of an end-to-side aortofemoral Dacron prosthesis, whereas the other seven patients underwent replantation of the IMA into the Dacron prosthesis. All patients did well postoperatively. In the 14 general surgical patients, intestinal viability and collateral mesenteric blood flows were determined, which demonstrated that the presence of audible arterial blood flow correlated with ultimate bowel viability. We recommend the use of the Doppler ultrasonic flowmeter in abdominal aortic revascularization procedures to determine the need for IMA reconstruction as well as in general surgical procedures where the surgeon desires a more objective assessment of intestinal viability.

(Arch Surg 114:165-168, 1979)