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Cited by 116Abdominal vascular conditions and treatmentsVascular anomalies and interventionsAortic Thrombus and Embolism

Acute superior mesenteric ischaemia

Open access
Wilson, C, Gupta, R, Gilmour, D G, Imrie, C W·1987·Journal of British Surgery
DOI 10.1002/bjs.1800740417
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Abstract

A review of case records and post-mortem reports from Glasgow Royal Infirmary over the past 12 years identified 102 patients with acute superior mesenteric ischaemia, 53 (52 per cent) of whom were first diagnosed at post mortem. Overall mortality was 92 per cent and mortality in the 49 patients diagnosed in life was 84 per cent. Fourteen patients (14 per cent) underwent exploratory laparotomy only with no survivors, 26 (25 per cent) had bowel resection alone with 7 surviving, and 9 (9 per cent) had a revascularization procedure, 5 requiring additional bowel resection, with only one surviving. Survivors were usually younger, had a shorter history and less extensive bowel infarction. Improvements in intensive care and nutritional support with the greater use of revascularization procedures in the past 6 years have barely influenced mortality. Delays in diagnosis and treatment contribute to the poor results. Earlier diagnosis might be aided by measuring serum inorganic phosphate and, coupled with the more widespread use of emergency angiography and revascularization procedures, holds out the best hope for future improvement.

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Crossref · 10.1002/bjs.1800740417

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  • In the general population studies, the proportion of women among acute mesenteric ischaemia cases was 58.3% (95% CI 56.5 to 60.2).

    “The studies included in our analysis of the incidence in the general population, indicate a significantly higher proportion of women, at 58.3% (95% CI 56.5 to 60.2).”

    From Incidence and outcomes of acute mesenteric ischaemia: a systematic review and meta-analysis (2022) · cites this paper as [17]

    Table 2 (page unavailable) reports 56 women and 46 men among 102 cases, supporting a higher proportion of women in this study. The paper does not report the citing authors’ pooled estimate of 58.3% or its 95% confidence interval; its own female proportion is approximately 54.9%. (LLM, conf=0.88)

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  • The real mortality rate of acute mesenteric ischaemia is likely higher than observed because a substantial number of cases are diagnosed only at autopsy and autopsy rates are low.

    “The real mortality rate is likely higher, since a substantial number of AMI cases are diagnosed only at autopsy,15 17 and the autopsy rate in most studied countries is generally very low”

    From Incidence and outcomes of acute mesenteric ischaemia: a systematic review and meta-analysis (2022) · cites this paper as [17]

    The Abstract reports that 53 of 102 cases were first diagnosed at post mortem, and that mortality was 92% overall versus 84% among patients diagnosed in life. The Discussion describes this hospital’s post-mortem rate as around 20%, but the paper does not establish that autopsy rates are generally low across most studied countries or explicitly estimate a higher true mortality rate. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • The mean incidence of acute mesenteric ischaemia in the general population was 6.2 per 100 000 person years (95% CI 1.9 to 12.9).

    “The mean incidence of AMI was 6.2 (95% CI 1.9 to 12.9) per 100 000 person years.”

    From Incidence and outcomes of acute mesenteric ischaemia: a systematic review and meta-analysis (2022) · cites this paper as [17]

    Patients and methods (page unavailable) reports 102 cases during January 1973–August 1984 in a catchment population averaging around 200,000. The Discussion (page unavailable) suggests incidence increased, but neither passage reports a mean incidence of 6.2 per 100,000 person-years or the stated 95% confidence interval; searches for those figures found no matching passage. (LLM, conf=0.76)

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Cites

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Research works printed but not linked: 1

  1. Br. J. Surg., Vol. 74, No. 4, April 1987

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Related

Authors
Wilson, C., Gupta, R., Gilmour, D. G., & Imrie, C. W.
Affiliations
Glasgow Royal Infirmary (GB)
Corresponding author
Wilson, C
ORCID
Venue
Journal of British Surgery
Publisher
Oxford University Press (OUP)
Published
1987-04-01
Volume
74
Issue
4
Pages
279-281
ISSN
  • 0007-1323 (ISSN-L)
  • 1365-2168
DOI
10.1002/bjs.1800740417
OpenAlex
W2132055068
Cited by
116
References
12
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 3 · 2015: 2 · 2014: 2 · 2012: 3
FWCI
2.92
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • British journal of surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
  • Health Sciences › Medicine › Surgery › Vascular anomalies and interventions
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Thrombus and Embolism
Keywords
mesenteric ischemia, mortality, bowel resection, mesenteric revascularization, postmortem diagnosis, serum phosphorus, emergency angiography, delayed diagnosis, intensive care, nutritional support
MeSH terms
Acute Disease, Embolism, Humans, Ischemia, Mesenteric Arteries, Mesenteric Vascular Occlusion, Prognosis, Scotland

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