JAAP J. HOMAN VAN DER HEIDE, M.D.; JAN H. KLEIBEUKER, M.D.
To the editor: A 63-year-old man had been treated for abdominal angina with an aortomesenteric bypass 2 years previously; the patient had severe intestinal ischemia during an episode of dehydration. Angiography showed a total occlusion of the graft and of both the superior and inferior mesenteric arteries. Small collateral vessels allowing marginal mesenteric bloodflow were present. Oral food was not tolerated and surgical therapy was not feasible in this situation.
Continuous enteral nutrition through a nasogastric tube was started in order to stimulate the collateral circulation. Volume and caloric density were such that there were no ischemic symptoms. Initially only
VAN DER HEIDE JJH, KLEIBEUKER JH. Intestinal Circulation, Enteral Nutrition, and Inoperable Abdominal Angina. Ann Intern Med. ;107:592. doi: 10.7326/0003-4819-107-4-592_1
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Published: Ann Intern Med. 1987;107(4):592.
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