Mar 29, 2021
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Intestinal infarction. Why does the seizure occur?

Bowel infarction is a serious condition. It entails dangerous complications. In fact, an intestinal infarction means a process against the background of clogging of arterial and venous vessels with blood clots, necrotization of the intestinal walls can develop, and then inflammation in the abdominal cavity and peritonitis.

About what constitutes an intestinal infarction, and how to cope with it, was told by the candidate of medical sciences, pediatric surgeon of the surgical department No. 2 of the Russian Children’s Clinical Hospital N.I. Pirogova Alexey Stepanov

Why does intestinal infarction occur?

Intestinal infarction is understood as one of the rather life-threatening conditions, when the necrosis of a section of the wall occurs due to the cessation of blood flow to it. If the patient is not helped in time, the risk of death is 100%. The pathology is acute, while it does not occur so often. Previously, mostly elderly people faced it, but now the problem, as experts say, is getting younger.

“In children, for example, the disease is infrequent, but most often it develops in them against the background of volvulus of the intestinal tube. A volvulus can be if we are faced with adhesive intestinal obstruction, when connective tissue cords are formed in the abdominal cavity, which stretch from the anterior abdominal wall to the intestinal loop and around the so-called. The intestinal stranga loop can be wrapped, and there can be a circulatory disorder in its wall, ”says Aleksey Stepanov.

Another option is volvulus as a result of incomplete bowel rotation, the surgeon says. “This is a congenital disease, when any period of intestinal rotation is disturbed, is disturbed even in utero, and the child is born with such a pathology when the whole small intestine is in the right parts of the abdominal cavity, and the large intestine is folded in the form of a shotgun and is in the left half. Most importantly, the small intestine and part of the colon share a common mesentery. This is a film through which the vessels supplying the intestines pass, ”notes Aleksey Stepanov.

Often, the surgeon says, with volvulus, the entire small intestine is wrapped, circulatory disorders occur in its wall with the development of intestinal infarction and with necrosis of very large areas of the intestine, sometimes the entire small intestine. “Therefore, in case of detection of such a disease as incomplete bowel turn, or in the presence of an appropriate clinic, it is necessary to perform an operation as soon as possible to restore normal anatomical relationships of the abdominal organs, or to be always on the alert that such a serious disease as volvulus can happen in any time. The combination of an incomplete twist with a volvulus is called Ledd’s syndrome, ”the surgeon notes. If such a disease is detected, it is necessary to consult a surgeon as soon as possible, the specialist emphasizes.

Another cause of intestinal infarction is mesenteric thrombosis, which is most common in adults. In children, this is very rare, but it is not excluded. It happens that it develops against the background of any vascular pathology, most often of the arteries, for example, as a result of endarteritis, there may be detached thrombosis, but not only of the mesenteric vessels, but also of other great vessels, incl. vessels of the mesentery. If mesenteric thrombosis occurs, then there is a so-called. mesenteric thrombosis with the development of intestinal infarction.

“In this case, a rather characteristic clinical picture develops, which manifests itself in the form of severe abdominal pain, nausea and vomiting, a general serious condition, severe intoxication, dry skin. Sometimes blood streaks first appear in the stool, sometimes intense intestinal bleeding occurs, ”the specialist notes. When such symptoms appear, especially if it is already known that the patient suffers from endarteritis, says Alexey Stepanov, it is necessary first of all to exclude mesenteric thrombosis, and also to consult a surgeon in time.

How to treat

Naturally, the treatment of intestinal infarction as a result of volvulus or acute mesenteric thrombosis is only surgical, emphasizes Alexey Stepanov. “We need to complete the operation as soon as possible. In case of bloat, eliminate it in the hope that the blood supply to the intestinal wall will be restored. If recovery does not take place, then resections are performed, sometimes extensive ones, with the formation of ileostomas or anastomoses, ”the doctor notes.

Approximately similar situations, the specialist emphasizes, occur with acute mesenteric thrombosis. “If it is possible to carry out the operation in the early stages, then theoretically thromboectomy is possible – the removal of a blood clot from the supplying vessel. Unfortunately, this is extremely rare. Both diseases are accompanied by extensive intestinal necrosis, extended necrosis, which force the surgeon to perform resection of a significant part of the small intestine, which in the future can lead to the development of the so-called. short bowel syndrome, because in this case there are pronounced disorders of intestinal absorption “, – says Alexey Stepanov.

Patients are on parenteral nutrition for a long time, that is, all the substances necessary for life are received through a vein. Today, methods are used to lengthen the intestines, but these are very complex and multi-stage operations, and in order to avoid this, you need to see a doctor in time, says Alexey Stepanov.

You should consult a doctor in time so as not to treat the outcomes and complications.

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