Acute mesenteric ischemia
Abstract
Acute mesenteric ischemia is caused by a critical reduction in intestinal blood flow that frequently results in bowel necrosis and is associated with a high mortality. Clinicians must maintain a high index of suspicion because a prompt diagnosis and early aggressive treatment before the onset of bowel infarction results in reduced mortality. Medical management includes aggressive rehydration and the use of antibiotics, anticoagulation, vasodilators, and inhibitors of reperfusion injury. If acute mesenteric ischemia is suspected, early angiography is imperative, as it permits accurate diagnosis and possible therapeutic intervention. Therapeutic options during angiography depend on the cause of ischemia and include administering intra-arterial vasodilators and/or thrombolytic agents and angioplasty with or without stent placement. If interventional techniques are not possible or if the patient presents with suspicion of bowel infarction, surgery is warranted. Surgical techniques include superior mesenteric artery embolectomy or visceral artery bypass, which should be used before bowel resection to ensure only resection of nonviable bowel.
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The higher mortality of arteriosclerotic occlusions compared to embolic occlusions is probably due to a larger and more poorly compensated bowel ischemia.
“Moreover, arteriosclerotic occlusions were associated with higher mortality compared to embolic occlusions (53% vs. 34%; P = 0.11), probably due to a larger and more poorly compensated bowel ischemia [1, 11].”
From Results after intraoperative open and endovascular revascularization of acute mesenteric ischemia requiring a laparotomy (2023) · cites this paper as [1]
Arteriosclerotic occlusions were associated with higher mortality compared to embolic occlusions (53% vs. 34%; P=0.11).
“Moreover, arteriosclerotic occlusions were associated with higher mortality compared to embolic occlusions (53% vs. 34%; P = 0.11), probably due to a larger and more poorly compensated bowel ischemia [1, 11].”
From Results after intraoperative open and endovascular revascularization of acute mesenteric ischemia requiring a laparotomy (2023) · cites this paper as [1]
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- Authors
- Berland, T., & Oldenburg, W. A.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Oldenburg, W. Andrew
- Venue
- Current Gastroenterology Reports
- Published
- 2008-06
- Volume
- 10
- Issue
- 3
- Pages
- 341-346
- ISSN
- 1522-8037 (ISSN-L)
- 1534-312X
- OpenAlex
- W4232915307
- Cited by
- 94
- References
- 32
- Citations by year
- 2026: 2 · 2025: 3 · 2023: 8 · 2022: 2 · 2021: 4 · 2020: 7 · 2019: 4 · 2018: 5 · 2017: 2 · 2016: 6 · 2015: 4 · 2014: 6 · 2013: 10 · 2012: 6
- FWCI
- 8.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Gastroenterology Reports (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, intestinal necrosis, bowel infarction, ischemia-reperfusion injury, angiography, thrombolysis, angioplasty, stenting, bowel resection, mortality
- MeSH terms
- Humans, Intestines, Ischemia, Mesenteric Vascular Occlusion
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