Mesenteric vascular disease.

Mesenteric vascular disease continues to be associated with an extremely high mortality. It is not necessarily a disease of old age: 20 of the 75 patients in our series were less than 60 years of age. In retrospect, earlier diagnosis and a more aggressive approach could have improved the survival rate of 17.3 percent. Surgeons have been slower to accept revascularization of the bowel compared with similar procedures in the extremities and other organs. A greater understanding of the disease and the benefits of surgery should yield better results. Early laparotomy with aortomesenteric grafting and planned resection 24 hours later, as used in one patient, is advocated as a useful technique.