This report deals with the perioperative management of ten patients with acute superior mesenteric artery occlusion. All ten patients survived after the surgery. Anesthesia in six patients were maintained with isoflurane, and in four patients with propofol, fentanyl and ketamine (PFK). Total intravenous anesthesia with PFK may provide stable anesthetic managements in superior mesenteric artery occlusion. After the operation patients were treated to control severe infection, multiple organ failure and coagulopathy. Three patients who have only 7, 10 or 5 cm of jejunum are undergoing home parenteral nutrition for short bowel syndrome. Early treatment of intestinal ischemia is essential because necrosis may develop as the condition progresses. The intestine should be preserved to the great extent possible in surgery for acute superior mesenteric arterial occlusion to obtain good long-term quality of life.
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