Acute Mesenteric Ischemi a (AMI): A surgical perspective

Abstract

Acute mesenteric ischemia (AMI) is a rare surgical emergency as it involves perfusion and need frequent surgical interventions. It is a life threatening emergency with a poor prognosis. It is classified according to the etiological basis thromboembolism, non-obstructive and venous origin. AMI has various risk factors ranging from cardiac arrhythmias to the intraabdominal hypertension. Apart from the signs and symptoms, the multi-detector computer tomography remains a diagnostic tool with accuracy. In the management of AMI patients' initial resuscitation, hydration and analgesia play important role, however the operative /interventional management is either endovascular thrombectomy with or without stenting when there is no bowel involvement or peritonitis. The laparotomy with open vascular thrombectomy with vascular graft, it is indicated when bowel involvement and peritonitis patients. Often the whole bowel is gangrenous and no further treatment is needed because of certain mortality. The 2 nd step is to know the extent of bowel involvement meticulously and resection of bowel with necrosis or gangrene with anastomosis, further relook laparotomies and resection of the bowel may be need. Initially abdomen will be closed with Bagota bag or VAC (Vacuum Assisted Closed) dressing and final staged abdominal closer, once pathology resolves completely. As far as prevention of all types

Extensive Aeroportia, Operate or Not to Operate? A Report of a Challenging Case

“…Acute mesenteric ischemia (AMI) is a life-threatening surgical emergency that carries significant morbidity and mortality. The usual presentation of AMI is “pain out of proportion” which may not be present in all cases [ 3 ]. One of the atypical presentations is portal venous gas, in an otherwise non-tender abdomen.…”