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July 1962

Metabolic Studies in Acute Small-Bowel Ischemia

Author Affiliations

From the Department of Surgery, University of Michigan Medical School.; John and Mary R. Markle Scholar in Medical Science and U.S. Public Health Service Career Development Awardee (Dr. Zuidema).

Arch Surg. 1962;85(1):130-135. doi:10.1001/archsurg.1962.01310010134018

Technical advances in vascular surgery during the last decade have made possible the correction of certain arterial lesions of the gastrointestinal tract.6,9 In contrast to this achievement is the relative paucity of knowledge concerning metabolic aberrations induced by intestinal ischemia. The clinical diagnosis of acute massive small-bowel ischemia is usually not difficult. When suspected, urgent celiotomy is indicated for both diagnosis and treatment and the delay involved in performing complex diagnostic tests is in most cases unwarranted. There remain, however, 2 areas in which research is clearly indicated. First, the residual effect of acute small-bowel ischemia has been evaluated in only a few cases.5,13,15 A syndrome of diarrhea, hypoproteinemia, and malabsorption has been observed in these cases, but this needs further documentation. Second, limited lesions in which mucosal integrity is impaired are difficult to diagnose if the bowel remains viable.12 Such lesions occur with embolization or thrombosis