SECOND LOOK PROCEDURE AFTER EMBOLECTOMY FOR ACUTE MESENTERIC ARTERY EMBOLISM -A CASE REPORT-

Acute mesenteric artery embolism is a curable disease if the diagnosis and therapy are instituted before irreversible changes have occurred. We experienced a case of acute mesenteric artery embolism which was treated by second look procedure about 40 hours after embolectomy that permitted us to excise the small intestine in a minimal range. A 71-year-old man was admitted to the hospital because of severe abdominal pain. Superior mesenteric artery angiogram demonstrated embolus completely occluding the SMA. Emergency laparotomy was performed. Large segment of the intestine revealed ischemic change. We performed embolectomy of SMA. About 40 hours after embolectomy, second look procedure was performed. Only small segment of the intestine was necrosed. Bowel resection about 150 cm and anstomosis was carried out. The patient died of cardiac arrest on the 66th day after onset of th diseases. Second look procedure after embolectomy appears useful for evaluation of bowel viability.