ESTES guidelines: acute mesenteric ischaemia
Open accessAbstract
PURPOSE: Acute mesenteric ischaemia (AMI) accounts for about 1:1000 acute hospital admissions. Untreated, AMI will cause mesenteric infarction, intestinal necrosis, an overwhelming inflammatory response and death. Early intervention can halt and reverse this process leading to a full recovery, but the diagnosis of AMI is difficult and failure to recognize AMI before intestinal necrosis has developed is responsible for the high mortality of the disease. Early diagnosis and prompt treatment are the goals of modern therapy, but there are no randomized controlled trials to guide treatment and the published literature contains a high ratio of reviews to original data. Much of that data comes from case reports and often small, retrospective series with no clearly defined treatment criteria. METHODS: A study group of the European Society for Trauma and Emergency Surgery (ESTES) was formed in 2013 with the aim of developing guidelines for the management of AMI. A comprehensive literature search was performed using the Medical Subject Heading (MeSH) thesaurus keywords "mesenteric ischaemia", "bowel ischaemia" and "bowel infarction". The bibliographies of relevant articles were screened for additional publications. After an initial systematic review of the literature by the whole group, a steering group formulated questions using a modified Delphi process. The evidence was then reviewed to answer these questions, and recommendations formulated and agreed by the whole group. RESULTS: The resultant recommendations are presented in this paper. CONCLUSIONS: The aim of these guidelines is to provide recommendations for practice that will lead to improved outcomes for patients.
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Despite several clinical guidelines mentioning vasodilator therapy for NOMI, only a few small studies have been published.
“Despite several clinical guidelines mentioning vasodilator therapy for NOMI [133–135], only a few small studies have been published [136, 137].”
From Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. (2022) · cites this paper as [135]
To date, there are three surgical society guidelines with a tendency for an endovascular-first strategy.
“To date, there are three surgical society guidelines with a tendency for an endovascular-first strategy [2, 9, 12].”
From Results after intraoperative open and endovascular revascularization of acute mesenteric ischemia requiring a laparotomy (2023) · cites this paper as [2]
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- Authors
- Tilsed, J. V. T., Casamassima, A., Kurihara, H., Mariani, D., Martinez, I., Pereira, J., Ponchietti, L., Shamiyeh, A., al-Ayoubi, F., Barco, L. A. B., Ceolin, M., D’Almeida, A. J. G., Hilario, S., Olavarria, A. L., Ozmen, M. M., Pinheiro, L. F., Poeze, M., Triantos, G., Fuentes, F. T., Sierra, S. U., Soreide, K., & Yanar, H.
- Affiliations
- Hull University Teaching Hospitals NHS Trust (GB)
- Fondazione Humanitas per la Ricerca (IT)
- Azienda Ospedaliera Ospedale Civile di Legnano (IT)
- Centro Hospitalar Tondela-Viseu (PT)
- Milton Keynes Hospital (GB)
- Kepler Universitätsklinikum (AT)
- Mafraq Hospital (AE)
- Centro Hospitalar de Vila Nova de Gaia (PT)
- Hospital de Santo André (PT)
- Hospital São Teotónio (PT)
- Maastricht University Medical Centre (NL)
- General Hospital of Rhodes (GR)
- Hospital General Universitario Gregorio Marañón (ES)
- Hospital de Galdakao (ES)
- Istanbul University (TR)
- Corresponding author
- Tilsed, J. V. T.
- ORCID
- Venue
- European Journal of Trauma and Emergency Surgery
- Published
- 2016-01-28
- Volume
- 42
- Issue
- 2
- Pages
- 253-270
- ISSN
- 1863-9933 (ISSN-L)
- 1863-9941
- PMC
- PMC4830881
- OpenAlex
- W2292482254
- Cited by
- 382
- References
- 142
- Citations by year
- 2026: 22 · 2025: 29 · 2024: 41 · 2023: 42 · 2022: 55 · 2021: 51 · 2020: 66 · 2019: 28 · 2018: 32 · 2017: 15 · 2016: 1
- FWCI
- 28.04
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- European Journal of Trauma and Emergency Surgery (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- Hacettepe University Institutional Repository (hacettepe.edu.tr) (submittedVersion, cc-by)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Emergency Medicine › Appendicitis Diagnosis and Management
- Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
- Keywords
- acute mesenteric ischemia, mesenteric infarction, intestinal necrosis, early diagnosis, early treatment, intestinal ischemia, Delphi consensus, treatment guidelines
- MeSH terms
- Anti-Bacterial Agents, Anticoagulants, Fluid Therapy, Humans, Oxygen Inhalation Therapy, Vascular Surgical Procedures, Risk Assessment, Early Diagnosis, Multidetector Computed Tomography, Early Medical Intervention, Symptom Assessment, Mesenteric Ischemia
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