Cited by 156Abdominal vascular conditions and treatmentsIntestinal and Peritoneal AdhesionsAppendicitis Diagnosis and Management

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Acute Occlusive Mesenteric Ischemia: Surgical Management and Outcomes

Edwards, Matthew S., Cherr, Gregory S., Craven, Timothy E., Olsen, Amy W., Plonk, George W., Geary, Randolph L., Ligush, John L., Hansen, Kimberley J.·2003·Annals of Vascular Surgery

DOI 10.1007/s10016-001-0329-8

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Abstract

Acute mesenteric ischemia secondary to arterial occlusion (AMI) remains a highly lethal condition. To examine recent trends in management and associated outcomes, we examined our institutional experience over a recent 10-year period. All patients treated for AMI between January 1990 and January 2000 were identified (76 patients, 77 cases) and their medical records examined. At presentation, 64% demonstrated peritonitis and 30% exhibited hypotension. The interval from symptom onset to treatment exceeded 24 h in 63% of cases. Etiology was mesenteric thrombosis in 44 patients (58%) and embolism in 32 patients (42%). Thirty-five patients (46%) had prior conditions placing them at high risk for the development of AMI including chronic mesenteric ischemia (n = 26) and inadequately anticoagulated chronic atrial fibrillation (n = 9). Surgical management consisted of exploration alone in 16 patients, bowel resection alone in 18 patients, and revascularization in 43 patients, including 28 who required concomitant bowel resection. Overall, intestinal necrosis was present in 81% of cases. Perioperative mortality was 62% and long-term parenteral nutrition (TPN) was required in 31% of survivors. Peritonitis (odds ratio [OR] 9.4, 95% confidence interval [CI] 1.6, 54.0; p = 0.012 and bowel necrosis (OR 10.4, CI 1.9, 56.3; p = 0.007) at presentation were independent predictors of death or survival dependent upon TPN. We conclude that AMI remains a highly lethal condition due in large part to advanced presentation and inadequate recognition and treatment of patients at high risk.

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Authors: Edwards, M. S., Cherr, G. S., Craven, T. E., Olsen, A. W., Plonk, G. W., Geary, R. L., Ligush, J. L., & Hansen, K. J.
Affiliations: Wake Forest University Health Sciences (US)
Corresponding author: Hansen, Kimberley J.
ORCID: Edwards, Matthew S.
Craven, Timothy E.
Venue: Annals of Vascular Surgery
Publisher: Elsevier BV
Published: 2003-01
Volume: 17
Issue: 1
Pages: 72-79
ISSN: 0890-5096 (ISSN-L)
DOI: 10.1007/s10016-001-0329-8
OpenAlex: W2147715732
Cited by: 156
References: 29
Citations by year: 2026: 1 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 6 · 2021: 5 · 2020: 5 · 2019: 6 · 2018: 6 · 2017: 5 · 2016: 8 · 2015: 6 · 2014: 10 · 2013: 6 · 2012: 12
FWCI: 8.79
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Annals of Vascular Surgery (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
Health Sciences › Medicine › Emergency Medicine › Appendicitis Diagnosis and Management
Keywords: acute mesenteric ischemia, arterial occlusion, mesenteric thrombosis, mesenteric embolism, bowel resection, mesenteric revascularization, intestinal necrosis, peritonitis, atrial fibrillation, anticoagulation, parenteral nutrition, perioperative mortality, mortality risk factors
MeSH terms: Adult, Aged, Embolism, Female, Humans, Male, Mesenteric Arteries, Mesenteric Vascular Occlusion, Middle Aged, Morbidity, Peritonitis, Retrospective Studies, Thrombosis, Vascular Surgical Procedures, Logistic Models, Treatment Outcome

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Acute Occlusive Mesenteric Ischemia: Surgical Management and Outcomes

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