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05-02-2008, 11:50 AM
m Causes: Embolism or thrombosis of Mesentric arteries Related loops develop strangulation & gangrene.
m Clinical Picture: Adynamic obstruction + strangulation.
The patient is usually cardiac presented with acute abdomen and shock:
1- Dull aching pain (never colic).
2- Early vomiting with minimal distention.
3- Constipation is delayed. Blood and mucus may be passed.
4- Rigidity, tenderness, rebound tenderness (strangulation).
5- Silent abdomen in auscultation.
6- PR:. blood stained finger.
m Investigation: X-ray no gas in the small intestine, as intestine is filled with exudation from congested capillaries.
m Treatment: Early superior Mesentric embolectomy.
Late resection of gangrenous loop & anastomosis.
SOURCE: DR. AYMAN SALEM'S BOOK
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