Management of Injuries to the Superior Mesenteric Artery

Management of spontaneous and iatrogenic retroperitoneal haemorrhage: conservative management, endovascular intervention or open surgery?

“…In cases when such preop imaging is unavailable or impossible, the surgeon has several distinctive patterns of retroperitoneal haematoma to guide him to specific vascular injury. Detailed discussion of this is beyond the scope of this review article, suffice it to say that an upper abdominal midline supra‐mesocolic retroperitoneal haematoma is associated with bleeding from the supra‐renal aorta, coeliac axis or the superior mesenteric artery (94,95). The mid‐abdominal midline infra‐mesocolic retroperitoneal haematoma is associated with proximal renal artery, infra‐renal aorta or caval injury (96).…”

Comparisons of Three Surgical Procedures on Intestine Ischemia Reperfusion Injury in a Superior Mesenteric Artery Injury Model

“…Consequently, injuries in these zones should be repaired either primarily or with an interposition shunt [32]. Sufficient facilities, time, and expertise may not be available in forward battle field hospitals for definitive vascular operations.…”

Isolated injury of the superior mesenteric artery caused by a lap belt in a child

“…It is important to remember that if mesenteric arterial disruption occurs proximal to the first jejunal branch, bowel ischemia and infarction may result. The acute occlusion or prolonged hypoperfusion of 2 or more branches of the mesenteric artery is poorly tolerated, and early revascularization is essential to reverse ischemia before bowel infarction occurs [26][27][28]. Anyway, concerning the treatment of SMA injury, there is the recent remarkable study of Asensio et al reporting on the multi-institutional experience of 34 centers in the United States, which collected 250 cases [1].…”