Incidence of acute thrombo-embolic occlusion of the superior mesenteric artery -: A population-based study

Objective. To determine the incidence of acute thrombo-embolic occlusion of the superior mesenteric artery (AOSMA) in a population-based study. Material. All clinical (n = 23,446) and forensic (n = 7569) autopsies performed in the city of Malmo between 1970 and 1982 (population 264,000-230,000 inhabitants). The autopsy rate was 87%. Methods. Calculation of the incidence of AOSMA with intestinal gangrene in those autopsies coded for bowel ischaemia (997/23,446 clinical and 9/7569 forensic autopsies). The operative procedures performed in 1970, 1976 and 1982 were also analysed. Results. Two forensic and 211 clinical autopsies demonstrated AOSMA with intestinal gangrene. Previous suspicion of intestinal ischaemia was noted in only 33%. Sixteen patients were operated. The cause-specific mortality was 6.0/1000 deaths. The incidence was 8.6/100,000 person years, increasing exponentially with age (p < 0.001). Mortality was 93%. Conclusions. The incidence and mortality of AOSMA is higher than previously reported from clinical series. There is seldom any suspicion of the diagnosis prior to death.