total small bowel infarction

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60 y.o male vasculopath (multiple prior myocardial infarctions, peripheral
vascular reconstructions, etc) s/p blunt abdominal trauma and repair of mid
small bowel blow-out injury (seatbelt injury).  Did well post-op, discharged
home.  Re-presents three weeks later with sudden onset abdominal pain.
Re-explored.  Entire small intestine infarcted, from ligament of Treitz to
ileocecal valve.

Therapeutic options?    Close abdomen, morphine drip, game over
or....resect, drain, support, hope he can be nourished parenterally if he
makes it to ICU.

What's the survival rate for total loss of small bowel in this age group?

Cordially, etc.

CM Ursic, MD
Santa Fe, USA

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