Clinical analysis of 66 cases of acute superior mesenteric artery embolism confirmed by surgery and angiography

Abstract

Objective To explore the clinical manifestation, treatment and prognosis of patients with acute superior mesenteric artery embolism (ASMAE). Methods From October 2012 to March 2018, the clinical data of 66 patients with ASMAE who were admitted to The First Affiliated Hospital of Chongqing Medical University were collected and retrospectively analyzed. The patients were divided into the death group and the survival group according to whether they died during hospitalization. The clinical features, the time of diagnosis and treatment methods of two groups were compared. T-test and chi-square test were performed for statistical analysis. Results Among 66 ASMAE patients, 16 were in the death group and 50 in the survival group. The age of the death group was (75.6±9.9) years, which was greater than that of the survival group ((68.1±13.2) years), and the difference was statistically significant (t=1.998, P=0.041). Among 16 dead patients, the case numbers of diagnosis time less than six hours, complicated with atrial fibrillation, peritoneal irritation sign, weakened or disappeared bowel sounds and complicated with systemic inflammatory response syndrome were 0, 14, 9, 9 and 16, respectively. However, among 50 survival patients, the case numbers of diagnosis time less than six hours, complicated with atrial fibrillation, peritoneal irritation sign, weakened or disappeared bowel sounds and complicated with systemic inflammatory response syndrome were 15 (30.0%), 30 (60.0%), 14 (28.0%), 14 (28.0%) and 36 (72.0%), respectively. The differences between two groups were all statistically significant (χ2=4.621, 4.125, 4.261, 4.261 and 4.134, all P<0.05). Conclusions When sudden severe abdominal pain occurs in elderly patients with atrial fibrillation, ASMAE should be alerted. Early (less than six hours) and correct diagnosis can improve the prognosis of the ASMAE patients. Key words: Atrial fibrillation; Risk factors; Mortality; Superior mesenteric artery embolism