Intestinal ischemia -- the basics.

INTRODUCTION: In this review the physiology of the intestinal circulation of importance for the understanding of intestinal ischemia is briefly outlined. PERSPECTIVES: The potential threat of massive intestinal vasoconstriction causing nonocclusive intestinal ischemia is discussed, as is the clinical importance of the reperfusion component of the ischemic injury. The clinical causes of intestinal ischemia are outlined. The delay in the usual clinical diagnostic process and its severe consequences are emphasized. Emphasis is made to discuss the special situation with sigmoid gangrene following surgery for ruptured aortic aneurysm. Laparotomy upon clinical suspicion of intestinal ischemia is generally recommended. The various therapeutic surgical measures available if diagnosis is made before massive intestinal gangrene are discussed.