Clinical Evaluation of Emergency Abdominal Angiography for Ileus

Plain abdominal roentgenography and barium meal study or barium enema have been the roentgenographic diagnostic means chiefly employed for ileus, yet these diagnostic technics have not always proved capable of getting its pathologic features in details. For this reason, even if the diagnosis of "ileus" may be made by such technics, information necessary about the measures that should then be taken has not been available.In an attempt to diagnose not only the severity of intestinal ischemia which is the core of the most important pathophysiologic change in this disease but also its cause and the location and area of its pathologic change as quickly as possible, the author has lately applied emergency abdominal angiography in ileus, and achieved the useful findings clinically. The findings are discussed, and their clinical significance described hereunder.The materials comprised a series of 32 mechanical ileus cases of 20 men and 12 women who were admitted under the diagnosis of acute abdomen in an emergency and whose plain abdominal x-ray films were noted the formation of fluid levels. For the angiography,15-35 ml of 76% urograf in was injected automatically under pressure selectively into either or both of the superior and inferior mesenteric arteries by Seldinger's method. The angiograms were, as a rule, taken with the patient in the supine position, and of in a case which was difficult for the patient to take the supine position because of abdominal pain, etc., the arterial puncture was made with the patient in the left lateral position, and the dorsoventral angiograms were taken by the use of a lateral x-ray apparatus. In order to accomplish this angiographic examination, it required 15-30minites.