Colonic involvement in acute mesenteric ischemia: Prevalence, risk factors, and outcomes
Abstract
Objectives This study aimed to investigate the prevalence, risk factors, and outcomes of colonic involvement in patients with acute mesenteric ischemia (AMI).Methods CT scans from a prospective cohort of 114 AMI patients treated in an intestinal stroke center between 2009 and 2018 were blindly reviewed by two radiologists. Colon involvement was defined on CT scan by the presence of at least one of the following CT colonic features: wall thickening, pneumatosis, decreased wall enhancement, dilatation, or perforation. In addition, the clinical, biological, and radiological characteristics of patients with and without colonic involvement were compared to identify risk factors for colonic involvement on CT and its impact on morbidity and mortality.Results Colonic involvement was identified in 32/114 (28%) patients with AMI, the right colon being more frequently involved (n = 29/32, 91%). Wall thickening (n = 27/32) was the most common CT finding. Occlusion of the inferior mesenteric artery was the only statistically significant risk factor for colonic involvement (35% vs. 15%, p = 0.02). Patients with colonic involvement on CT vs. those without had more frequently transmural colonic necrosis (13% vs. 0%, p = 0.006), short bowel syndrome (16% vs. 4%, p = 0.04), need for long-term parenteral support (19% vs. 5%, p = 0.03), and death during follow-up (22% vs. 10%, p = 0.03).Discussion In patients with AMI, colonic involvement is associated with increased morbidity and mortality and should be carefully searched for during initial CT scan assessment.Key points • In a prospective cohort of acute mesenteric ischemia patients from an intestinal stroke center, 28% had an associated colonic involvement on CT. • Colonic involvement on CT most commonly affected the right colon, and the occlusion of the inferior mesenteric artery was the only risk factor. • Colonic involvement on CT was associated with increased morbidity and mortality and should be carefully searched for during initial CT scan assessment.
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Colonic involvement occurs in approximately 28% of acute mesenteric ischemia cases, with the right colon more commonly affected.
“A prospective cohort study has highlighted the presence of colonic involvement in approximately 28% of acute mesenteric ischemia cases, with the right colon being more commonly affected [30].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [30]
Colonic involvement on CT is associated with increased morbidity and mortality in acute mesenteric ischemia.
“Colonic involvement in CT has been associated with increased morbidity and mortality in cases of acute mesenteric ischemia [30].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [30]
Occlusion of the inferior mesenteric artery is a significant risk factor for colonic involvement in acute mesenteric ischemia.
“Occlusion of the inferior mesenteric artery is a significant risk factor for colonic involvement [30].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [30]
Wall thickening is the most common CT finding in acute mesenteric ischemia cases with colonic involvement.
“Wall thickening is the most common CT finding in such cases [30].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [30]
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“Additional studies are necessary to corroborate the effect of albendazole in humans before implementation in clinical practice.”
Background
- Authors
- Ksouri, A., Copin, P., Bonvalet, F., Bozi, L., Cazals-Hatem, D., Garzelli, L., Panis, Y., Weiss, E., Castier, Y., Bouhnik, Y., Corcos, O., Vilgrain, V., Ronot, M., & Nuzzo, A.
- Affiliations
- Hôpital Beaujon (FR)
- Inserm (FR)
- Corresponding author
- Ronot, Maxime
- ORCID
- Venue
- European Radiology
- Published
- 2021-10-18
- Volume
- 32
- Issue
- 4
- Pages
- 2813-2823
- ISSN
- 0938-7994 (ISSN-L)
- 1432-1084
- OpenAlex
- W3207633420
- Cited by
- 14
- References
- 27
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 3 · 2023: 2 · 2022: 3
- FWCI
- 1.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Radiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Emergency Medicine › Appendicitis Diagnosis and Management
- Health Sciences › Medicine › Surgery › Gastrointestinal disorders and treatments
- Keywords
- acute mesenteric ischemia, colonic involvement, inferior mesenteric artery occlusion, colonic wall thickening, pneumatosis intestinalis, colonic necrosis, short bowel syndrome, parenteral nutrition dependence, mortality, risk factors, CT colonography
- MeSH terms
- Colon, Humans, Ischemia, Prospective Studies, Retrospective Studies, Risk Factors, Prevalence, Mesenteric Ischemia
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