JAAP J. HOMAN VAN DER HEIDE, M.D.; JAN H. KLEIBEUKER, M.D.
HOMAN VAN DER HEIDE JJ, KLEIBEUKER JH. Stimulation of Collateral Intestinal Circulation by Continuous Enteral Nutrition in Inoperable Mesenteric Vascular Insufficiency. Ann Intern Med. 1987;107:788. doi: 10.7326/0003-4819-107-5-788_2
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Published: Ann Intern Med. 1987;107(5):788.
To the editor: There is evidence that the extent of collateralization is proportional to the degree of arterial narrowing (1). Exercise has an additional beneficial effect on the induction of collateral vessels (2); patients with intermittent claudication are being placed in walk-training programs (3). Patients with two or three occluded aortic mesenteric stems can live without symptoms as long as the degree of collateralization can keep up with the rate of occlusion (4, 5).
A 63-year-old man who had an aorto-mesenteric bypass 2 years previously for abdominal angina had severe intestinal ischemia during an episode of dehydration. Angiography showed a
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