A study on 107 patients with acute mesenteric ischemia over 30 years
Open accessAbstract
Acute mesenteric ischemia (AMI) is a life threatening cause of acute abdomen. The purpose of this study is to define risk factors that predict the adverse outcome of AMI and to present our experience in the last 30 years. Hospital records and clinical data of 107 patients undergoing surgical intervention for AMI during the last 30 year period were reviewed and clinical outcomes as well as factors influencing mortality were analyzed. Mesenteric arterial thrombosis, arterial embolism and nonocclusive mesenteric ischemia (NOMI) were the cause of AMI in 68 (63.6%), 28 (26%), and 11 patients (10.2%), respectively. Abdominal pain was the most common presenting symptom (90.6%). Peritonitis was observed in 96 patients (89.7%) and 24 patients (22.4%) were in shock. Abdominal ultrasonography was performed in 46 patients (42%), abdominal CT angiography in 36 patients (33%) and mesenteric angiography in 12 patients (10.5%). All patients were operated and 11 (10%) patients underwent a second-look operation. Bowel resection was necessary in 101 patients (93.4%) during the initial operation and in seven patients (6.5%) during the second-look operation. The hospital mortality was 55.1%. Mortality was mainly due to multiorgan failure (43%). Diabetes mellitus, use of digoxine and antiplatelet drugs, duration of the symptoms until before surgery, existence of shock, low levels of the pH and bicarbonate and re-laparotomy were found to be negative predictors of the perioperative mortality. The use of total parenteral nutrition and CT angiography was found to be a protective factor against mortality. A high index of suspicion with prompt diagnostic evaluation with CT angiography may reduce time prior to surgical intervention which may lead to improved patient survival.
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Bowel resection alone can be life saving in 30% of patients with occlusive AMI.
“Revascularization is required in more than 70% of patients with occlusive AMI while bowel resection alone can be life saving in 30% of patients with occlusive AMI[97].”
From Ischemic bowel disease in 2021. (2021) · cites this paper as [97]
The Discussion (page unavailable) says no patients underwent revascularization, and the Results report bowel resection in 101 of 107 patients, supporting the point that patients can survive without revascularization. The paper does not report 30% survival after resection alone in occlusive AMI; it reports 55.1% mortality across its entire cohort, which also included nonocclusive cases. (LLM, conf=0.86)
Experimental — accuracy not yet measuredRevascularization is required in more than 70% of patients with occlusive AMI.
“Revascularization is required in more than 70% of patients with occlusive AMI while bowel resection alone can be life saving in 30% of patients with occlusive AMI[97].”
From Ischemic bowel disease in 2021. (2021) · cites this paper as [97]
The Discussion describes restoring blood flow as a basis of surgical management, but calls revascularization controversial and reports that none of the study’s patients underwent it. It gives no estimate that more than 70% of patients with occlusive AMI require revascularization. The Results report bowel resections and overall survival, but do not establish the citing sentence’s 30% figure for occlusive AMI. (LLM, conf=0.82)
Experimental — accuracy not yet measuredMesenteric venous thrombosis is considered a common cause of venous mesenteric ischemia that might lead to advanced bowel necrosis.
“In addition, mesenteric venous thrombosis Is considered a common cause of venous mesenteric ischemia that might lead to advanced bowel necrosis [4, 5].”
From Outcome of Acute Mesenteric Ischemia in Patients with COVID 19 Infection Our Experience at Royal Medical Services (2022) · cites this paper as [4]
The Introduction (page not provided) lists mesenteric venous thrombosis as a cause of acute mesenteric ischemia. It does not call it a common cause. The Discussion reports bowel necrosis in the study’s patients but does not link those cases specifically to venous thrombosis. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAcute mesenteric ischemia is a life-threatening surgical emergency resulting from abrupt occlusion of mesenteric vessels caused by atherosclerotic disease, arterial thromboembolism and dissection.
“Acute Mesenteric ischemia is a life threatening surgical emergency resulting from abrupt occlusion of mesenteric vessels caused by atherosclerotic disease, arterial thromboembolism and dissection.”
From Outcome of Acute Mesenteric Ischemia in Patients with COVID 19 Infection Our Experience at Royal Medical Services (2022) · cites this paper as [4]
The Introduction (page unavailable) describes acute mesenteric ischemia as life-threatening and requiring early surgical intervention, and identifies arterial thrombosis and embolism as causes. It does not identify atherosclerotic disease or dissection as causes. It also describes nonocclusive mesenteric ischemia, so the claim that the condition results from vessel occlusion is too broad. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe typical presentation in patients with acute mesenteric ischemia is severe abdominal pain out of proportion to physical signs along with bowel emptying, nausea, vomiting and diarrhea that might progress into peritonitis and bowel perforation.
“The typical presentation in patients with acute mesenteric ischemia is severe abdominal pain that is out of proportion of physical signs along with bowel emptying, nausea, vomitimg and Diarrhea that might progress into peritonitis and bowel perforation [1, 2, 4, 5].”
From Outcome of Acute Mesenteric Ischemia in Patients with COVID 19 Infection Our Experience at Royal Medical Services (2022) · cites this paper as [4]
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In a study by Etem Alhan et al. in 2012 on 107 patients with acute mesenteric ischemia, peritonitis was demonstrated in 89.7% of patients and 22.4% presented with shock status.
“In a study performed by Etem Alhan et al ., in 2012 on 107 patients with acute mesenteric ischemia, peritonitis was demostrated in 89.7% of patients and 22.4% of patients presented with shock status [4].”
From Outcome of Acute Mesenteric Ischemia in Patients with COVID 19 Infection Our Experience at Royal Medical Services (2022) · cites this paper as [4]
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- Authors
- Alhan, E., Usta, A., Çekiç, A., Saglam, K., Türkyılmaz, S., & Cinel, A.
- Affiliations
- Karadeniz Technical University (TR)
- Corresponding author
- Alhan, Etem
- Venue
- International Journal of Surgery
- Published
- 2012
- Volume
- 10
- Issue
- 9
- Pages
- 510-513
- ISSN
- 1743-9159 (ISSN-L)
- 1743-9191
- OpenAlex
- W2052727055
- Cited by
- 63
- References
- 29
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 5 · 2022: 4 · 2021: 4 · 2020: 7 · 2019: 5 · 2018: 2 · 2017: 3 · 2016: 7 · 2015: 12 · 2014: 4 · 2013: 3
- FWCI
- 6.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- International Journal of Surgery (publishedVersion)
- PubMed (publishedVersion)
- Bursa Uludag University - AVESIS (submittedVersion)
- 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, risk factors, mortality, nonocclusive mesenteric ischemia, arterial embolism, bowel resection, second-look surgery, multiple organ failure, CT angiography, total parenteral nutrition, antiplatelet agents, digoxin, diabetes mellitus, shock, peritonitis, abdominal ultrasound, mesenteric angiography
- MeSH terms
- Adult, Aged, Aged, 80 and over, Analysis of Variance, Female, Humans, Intestines, Ischemia, Male, Middle Aged, Retrospective Studies, Risk Factors, Digestive System Surgical Procedures, Vascular Diseases, Mesenteric Ischemia
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