الفهرس 
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Abstract
Mesenteric vascular occlusion (MVO) is a potentially life-threatening condition. patient represented by sever intraabdominal sepsis(SIAS). The authors advocate that the key principles of treating SIAS are early resuscitation and the earliest possible brief operative intervention to control the source of sepsis then, a second look operation is done to perform definitive repair according to the finding. Damage control surgery is defined as a rapid termination of an operation after control of life-threatening intra-abdominal sepsis followed by correction of physiologic abnormalities and then definitive management. Objectives this study was conducted to assess the benefits of applying the rules of damage control surgery in mesenteric vascular occlusion with comparison to one stage definite surgery (resection & diversion). Subjects and methods 40 patients were included in this study divided into 2 groups; group I, which included 20 patients with (MVO) with (SIAS) who were treated by damage control surgery and group II, which included 20 patients with (MVO) with (SIAS) who were treated by one stage resection and diversion. AF was the most common comorbidity and, risk factor in our patients, as it was present in one-third and one-fifth of cases in the damage control and one-stage groups respectively. About the surgical history, splenectomy was the commonest previous operation reported in the two study groups, as it was reported by a quarter of cases in both groups. Results Mesenteric vascular occlusion (MVO) is a potentially life-threatening condition. patient represented by sever intraabdominal sepsis(SIAS). The authors advocate that the key principles of treating SIAS are early resuscitation and the earliest possible brief operative intervention to control the source of sepsis then, a second look operation is done to perform definitive repair according to the finding. Damage control surgery is defined as a rapid termination of an operation after control of life-threatening intra-abdominal sepsis followed by correction of physiologic abnormalities and then definitive management. Objectives this study was conducted to assess the benefits of applying the rules of damage control surgery in mesenteric vascular occlusion with comparison to one stage definite surgery (resection & diversion). Subjects and methods 40 patients were included in this study divided into 2 groups; group I, which included 20 patients with (MVO) with (SIAS) who were treated by damage control surgery and group II, which included 20 patients with (MVO) with (SIAS) who were treated by one stage resection and diversion. AF was the most common comorbidity and, risk factor in our patients, as it was present in one-third and one-fifth of cases in the damage control and one-stage groups respectively. About the surgical history, splenectomy was the commonest previous operation reported in the two study groups, as it was reported by a quarter of cases in both groups. Results 1. In our study, pain is more severe in in one stage resection and diversion group, as analgesia requirement is more in this group, which may due to the skin incision and muscle dissection for ileostomy creation. 2. In the current study, Hospital stay showed no significant difference among both groups as the mean duration of hospitalization was 7.4 and 7.9 days in the damage control and one stage with diversion groups respectively but, some patients need more hospital stay as result of short bowel syndrome , malnutrition ,and need for total parenteral nutrition (TPN). 3. There was no statistically significant difference between studied groups regarding length of resected part and intra-peritoneal fluid characte. 4. About intra operative bleeding, there was no statistically significant difference between studied groups. 5. In our study, the rate of wound infection was high ,presented by 52% and 36% of patients in the damage control and one stage with diversion group respectively because, superficial wound infections are common in contaminated cases. 6. In our study, short bowel syndrome was encountered in 23 and 49% of patients in the damage control and one stage with diversion groups respectively, with no significant difference between the two groups. 7. Regarding the quality of life, we noticed a great improvement of each individual group (p < 0.001) when compared to its own baseline value.It is accepted that resection of the gangrenous part, resolution of sepsis and improvement of overall general condition after surgical intervention will have their positive impact on patient related quality of life. 8.For the mortality rate, there was no significant difference between the two approaches (p = 0.98), as it was encountered in 30% and 25% of cases in the damage control and one stage groups respectively. Conclusion: • Mesenteric vascular occlusion is a critical disease with high mortality rate. • Early detection and, resuscitation of mesenteric vascular occlusion leads to prevention of mortality of major cases. • Damage control surgery must be made as early as possible precede by proper resuscitation• Based on the previous data, although both surgical approaches did not differ regarding mortality outcome, the damage control option would be a better option as it was associated with less analgesic requirement, avoidance of stomal complications, and better quality of life.