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May 10, 1976

Mesenteric Arterial Insufficiency

JAMA. 1976;235(19):2129. doi:10.1001/jama.1976.03260450041032

Pathologically, atherosclerosis is a spotty disease of the arteries, both in the manner of affecting vessels individually and in its distribution among arteries generally. For the latter reason, in one group of persons (the largest group), coronary artery syndromes predominate, while in other groups, vascular involvement first affects other organs—the brain, the aorta, the lower extremities, the intestines.

Atherosclerosis of the mesenteric arteries provokes a variety of syndromes, depending on the extent of involvement, the rapidity with which it develops, and other factors. When atherosclerosis is extensive and suddenly complicated by thrombosis, intestinal infarction results in the clinical manifestations of an acute abdominal catastrophe. Then, whether or not the diagnosis has been confirmed by arteriography, surgical exploration of the abdomen almost always follows. At that time, the surgeon is faced with a difficult decision, namely, whether to do nothing, to resect infarcted bowel (a procedure leading to high mortality), or