Acute mesenteric ischemia (AMI): absence of renal insufficiency and performance of early bowel resection may indicate improved outcomes
Abstract
Purpose Acute mesenteric ischemia (AMI) is still associated with very high morbidity and mortality while the rareness and heterogeneity hamper the establishment of evidence-based guidelines. We sought to help standardize contemporary treatment by a cohort study at our tertiary center in the rising endovascular age.Methods A retrospective cohort study was conducted from 2005 to 2015. Patients with occlusive (OMI), non-occlusive (NOMI), and venous mesenteric ischemia (VMI) were compared with respect to clinical and treatment parameters as well as outcome.Results The study cohort consisted of 48 patients composed of 27 males and 21 females with an average age of 63 years and an average BMI of 25.1 kg/m 2. In 48% of patients (N=23), an acute arterial OMI had occurred while NOMI was present in 31% (N=15) and VMI in 21% (N=10). Interventional and intraoperative recanalizations were significantly more often required in OMI patients compared with other entities (p=0.003). Patients with venous mesenteric ischemia had a significant better overall survival than patients with OMI or NOMI in the univariate analysis (p=0.027). Patients with renal failure had a 14.7-fold higher relative risk (Cox p=0.013) and patients without bowel resection during primary surgery had a 17.8-fold higher relative risk (Cox p=0.047) to die of AMI in the postoperative course.Conclusions AMI remains a rare but oftentimes fatal disease. Our study provides evidence that outcome may depend on the AMI subtype, presence of renal insufficiency, and early bowel resection. Further research should help individualize treatment for optimized outcomes.
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The preoperative risk factors related to death of acute mesenteric ischemia after laparotomy remain unclear from existing studies because of variations in design and predictors investigated.
“The preoperative risk factors related to the death of AMI after laparotomy remain unclear from the existing studies because of variations in design and predictors investigated in these studies [9–12].”
From Preoperative Risk Factors for Short-Term Postoperative Mortality of Acute Mesenteric Ischemia after Laparotomy: A Systematic Review and Meta-Analysis (2020) · cites this paper as [9]
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Mesenteric Ischemia and Risk Factors: Scoping Review with ☸SAIMSARA
SAIMSARA (2026) · SAIMSARA Journal · doi:10.62487/c40d2c54
- Authors
- Matthaei, H., Klein, A., Branchi, V., Kalff, J. C., & Koscielny, A.
- Affiliations
- University Hospital Bonn (DE)
- Corresponding author
- Koscielny, Arne
- Venue
- International Journal of Colorectal Disease
- Published
- 2019-09-11
- Volume
- 34
- Issue
- 10
- Pages
- 1781-1790
- ISSN
- 0179-1958 (ISSN-L)
- 1432-1262
- OpenAlex
- W2972758359
- Cited by
- 21
- References
- 26
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 2 · 2022: 8 · 2021: 2 · 2020: 3
- FWCI
- 3.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Colorectal Disease (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 › Intestinal and Peritoneal Adhesions
- Keywords
- acute mesenteric ischemia, nonocclusive mesenteric ischemia, renal failure, recanalization, postoperative mortality, endovascular treatment
- MeSH terms
- Acute Disease, Female, Humans, Male, Middle Aged, Patient Care Team, Risk Factors, Digestive System Surgical Procedures, Cohort Studies, Multivariate Analysis, Survival Analysis, Treatment Outcome, Renal Insufficiency, Kaplan-Meier Estimate, Mesenteric Ischemia
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