Resuscitation
The patient with diagnosed occlusion of the superior mesenteric artery is stabilised before laparotomy by:
- treating any underlying condition, e.g. atrial fibrillation - caution should be taken since digitalization causes splanchnic vasoconstriction
- correcting shock with IV fluid, especially blood and plasma - central venous pressure and urine output are monitored
- bicarbonate may be needed to correct acidosis
- antiobiotic therapy should be commenced pre-operatively, e.g. cefuroxime 750mg / 6 hourly
- intra-arterial infusion of papaverine via the angiogram catheter may relieve some of the associated arterial spasm
- analgesia
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