Surgery>>>>>Arterial Disease
Question 9#

The treatment of nonocclusive mesenteric ischemia is:

A. Observation
B. Catheter infusion of papaverine
C. Stenting to prevent further spasm
D. Operative bypass of the SMA

Correct Answer is B

Comment:

The treatment of nonocclusive mesenteric ischemia is primarily pharmacologic with selective mesenteric arterial catheterization followed by infusion of vasodilatory agents, such as tolazoline or papaverine. Once the diagnosis is made on the mesenteric arteriography (Fig. below), intra-arterial papaverine is given at a dose of 30 to 60 mg/h. This must be coupled with the cessation of other vasoconstricting agents.

Mesenteric arteriogram showing non-occlusive mesenteric ischemia as evidenced by diffuse spasm of i ntestinal arcades with poor filling of intramural vessels.