Clinical Presentation, Etiology, and Diagnostic Considerations

David, Ramoncito A.; Erben, Young; Kalra, Manju

doi:10.1007/978-1-4939-1847-8_15

Cited by 4 publications

(5 citation statements)

References 36 publications

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“…Associated findings that suggest MVT include bowel wall thickening, pneumatosis, splenomegaly, and ascites [ 39 ]. Portal or mesenteric venous gas strongly suggests the presence of bowel infarction.…”

Section: Computed Tomography Angiography (Cta) Should Be Performed Asmentioning

confidence: 99%

Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery

et al. 2017

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Acute mesenteric ischemia (AMI) is typically defined as a group of diseases characterized by an interruption of the blood supply to varying portions of the small intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process will eventuate in life threatening intestinal necrosis. The incidence is low, estimated at 0.09–0.2% of all acute surgical admissions. Therefore, although the entity is an uncommon cause of abdominal pain, diligence is always required because if untreated, mortality has consistently been reported in the range of 50%. Early diagnosis and timely surgical intervention are the cornerstones of modern treatment and are essential to reduce the high mortality associated with this entity. The advent of endovascular approaches in parallel with modern imaging techniques may provide new options. Thus, we believe that a current position paper from World Society of Emergency Surgery (WSES) is warranted, in order to put forth the most recent and practical recommendations for diagnosis and treatment of AMI. This review will address the concepts of AMI with the aim of focusing on specific areas where early diagnosis and management hold the strongest potential for improving outcomes in this disease process.Some of the key points include the prompt use of CT angiography to establish the diagnosis, evaluation of the potential for revascularization to re-establish blood flow to ischemic bowel, resection of necrotic intestine, and use of damage control techniques when appropriate to allow for re-assessment of bowel viability prior to definitive anastomosis and abdominal closure.

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Section: Computed Tomography Angiography (Cta) Should Be Performed Asmentioning

confidence: 99%

Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery

et al. 2017

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“…The risk factors for atherosclerotic AMI are essentially the same as for coronary artery disease and peripheral artery disease. In addition, prolonged hypotension, hypovolemia, and hypercoagulable states have been associated with the risk of atherosclerotic AMI ( 13 ).…”

Section: Clinical Presentation Of Atherosclerotic (Thrombotic) Amimentioning

confidence: 99%

Acute Mesenteric Ischemia: A Challenge for the Acute Care Surgeon

Kärkkäinen

2021

Scand J Surg

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Acute mesenteric ischemia is considered uncommon, but it appears to be more frequent cause of acute abdomen than appendicitis or ruptured abdominal aortic aneurysm in elderly patients. Surgical treatment without revascularization is associated with high overall mortality, up to 80%. The modern treatment of acute mesenteric ischemia requires collaboration of gastrointestinal surgeons, vascular surgeons, and interventional radiologists. Early revascularization may reduce the overall mortality associated with acute mesenteric ischemia by up to 50%. Clinical suspicion and contrast-enhanced computed tomography performed at early stage are keys to improve outcomes of acute mesenteric ischemia treatment. This review summarizes what the acute care surgeon needs to know about acute mesenteric ischemia with special emphasis on slowly progressing “acute on chronic” mesenteric ischemia.

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“…16 In MVT, the most common positive radiological finding on the venous phase CTA is thrombus in superior mesenteric vein on venous phase CTA, described as the target sign. 17 have extensive bowel involvement. Systemic intravenous tPA has been successfully reported.…”

Section: Discussionmentioning

confidence: 99%

Retrospective study of mesenteric ischemia

Mandapati¹,

Jukuri²,

Nasika³

et al. 2020

Int Surg J

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Background: Acute mesenteric ischemia (AMI) is typically defined as a group of diseases characterized by an interruption of the blood supply to varying portions of the small intestine, leading to ischemia and secondary inflammatory changes.Methods: A monocentric retrospective study was conducted between 01 August 2013 and 31 December 2019; 24 AMI patients underwent surgery (17 men and 7 women). Retrospectively, the risk factors, management until diagnosis and mortality were evaluated.Results: Patients present with an acute pain of the abdomen. Diagnosis was provided by CT with contrast medium. The 30-day mortality was 45.8%, the late mortality was 25% and the overall mortality was 70.8%. For the <12 hours delay group, the mortality was 33.3%, and the mortality in the group with 12-24 hours delay was 80% and was 87.5% in the >24 hours after admission group.Conclusions: If untreated, this process will eventuate in life threatening intestinal necrosis. The incidence is low, estimated at 0.09-0.21% of all acute surgical admissions.

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Clinical Presentation, Etiology, and Diagnostic Considerations

Cited by 4 publications

References 36 publications

Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery

Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery

Acute Mesenteric Ischemia: A Challenge for the Acute Care Surgeon

Retrospective study of mesenteric ischemia

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