[Mesenteric infarct during digitalis poisoning].

So-called nonocclusive or spastic mesenteric infarction is a well-known complication of severe circulatory failure with low cardiac output and hypotension. In recent years, acute mesenteric insufficiency has been described in connection with certain drugs. Clinical and experimental evidence suggests a relationship between digitalis therapy, especially overdigitalization, and nonocclusive mesenteric infarction. Two cases are presented in support of this hypothesis. Both patients had digitalis intoxication and died from nonocclusive mesenteric infarction proven by surgery, autopsy and, in one case, arteriography. No cause other than digitalis intoxication (shock, severe cardiac failure or other drugs) could be found. Despite the frequent occurrence of digitalis intoxication, nonocclusive mesenteric infarction is a rare event. Interruption of digitalis therapy does not alter the usually fatal outcome. Experimental data with glucagon and phenoxybenzamine suggest that a therapeutic trial with these drugs might be worth while. Digitalis should be used with caution in shocked patients, since in these the splanchnic circulation is usually critical.