Acute Mesenteric Ischemia: The Challenge of Gastroenterology
Abstract
Intestinal ischemia has been classified into three major categories based on its clinical features, namely, acute mesenteric ischemia (AMI), chronic mesenteric ischemia (intestinal angina), and colonic ischemia (ischemic colitis). Acute mesenteric ischemia is not an isolated clinical entity, but a complex of diseases, including acute mesenteric arterial embolus and thrombus, mesenteric venous thrombus, and nonocclusive mesenteric ischemia (NOMI). These diseases have common clinical features caused by impaired blood perfusion to the intestine, bacterial translocation, and systemic inflammatory response syndrome. Reperfusion injury, which exacerbates the ischemic damage of the intestinal microcirculation, is another important feature of AMI. There is substantial evidence that the mortality associated with AMI varies according to its cause. Nonocclusive mesenteric ischemia is the most lethal form of AMI because of the poor understanding of its pathophysiology and its mild and nonspecific symptoms, which often delay its diagnosis. Mesenteric venous thrombosis is much less lethal than acute thromboembolism of the superior mesenteric artery and NOMI. We present an overview of the current understanding of AMI based on reported evidence. Although AMI is still lethal and in-hospital mortality rates have remained high over the last few decades, accumulated knowledge on this condition is expected to improve its prognosis.
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Acute mesenteric arterial occlusion accounts for approximately 67-95% of acute mesenteric ischemic cases.
“Acute mesenteric arterial occlusion accounts for approximately 67–95% of acute mesenteric ischemic cases [3,4].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [4]
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Monroy, D. M. C., Arango, F. G., Moreno, L. R., Chaves, C. E. R., Donoso-Samper, A., Nassar, R., & Isaza-Restrepo, A. (2022) · Annals of Medicine & Surgery · doi:10.1016/j.amsu.2022.104922 · Cited by 8 · see citing works
- Authors
- Yasuhara, H.
- Affiliations
- Teikyo University (JP)
- Corresponding author
- Yasuhara, Hiroshi
- Venue
- Surgery Today
- Published
- 2005-03-18
- Volume
- 35
- Issue
- 3
- Pages
- 185-195
- ISSN
- 0047-1909 (ISSN-L)
- 0941-1291
- 1436-2813
- OpenAlex
- W2013685910
- Cited by
- 301
- References
- 90
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 9 · 2023: 4 · 2022: 11 · 2021: 14 · 2020: 12 · 2019: 8 · 2018: 11 · 2017: 19 · 2016: 22 · 2015: 21 · 2014: 19 · 2013: 16 · 2012: 17
- FWCI
- 13.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Surgery Today (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 › Pulmonary and Respiratory Medicine › Aortic Thrombus and Embolism
- Keywords
- acute mesenteric ischemia, nonocclusive mesenteric ischemia, mesenteric vein thrombosis, superior mesenteric artery embolism, intestinal ischemia, ischemia-reperfusion injury, bacterial translocation, systemic inflammatory response syndrome, intestinal microcirculation, mortality
- MeSH terms
- Acute Disease, Combined Modality Therapy, Diagnostic Imaging, Female, Fibrinolytic Agents, Gastroenterology, Humans, Intestines, Ischemia, Magnetic Resonance Imaging, Male, Mesenteric Vascular Occlusion, Mesenteric Veins, Phlebography, Prognosis, Severity of Illness Index, Tomography, X-Ray Computed, Vascular Diseases, Survival Rate, Critical Illness, Treatment Outcome, Embolectomy
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