Acute mesenteric ischemia – a persistent problem

Czech version

Authors: M. Kunychka; J. Váňa; M. Žáček; M. Chromčiková
Authors‘ workplace: Chirurgia, Fakultná nemocnica s poliklinikou Žilina, Slovenská republika
Published in: Rozhl. Chir., 2023, roč. 102, č. 6, s. 228-235.
Category: Review
doi: https://doi.org/10.33699/PIS.2023.102.6.228–235

Overview

Acute mesenteric ischemia is a disease with a relatively low incidence (0,02–0,9% of acute surgical hospitalizations) but a very high mortality rate which can reach up to 100% without early revascularization. Given the above, prompt and accurate diagnosis and subsequent surgical intervention is the cornerstone of treatment and essential to reduce the high mortality rate. Early revascularization can reduce overall mortality by up to 50%. Treatment of acute mesenteric ischemia requires the cooperation of gastrointestinal surgeons, vascular surgeons and interventional radiologists. Thorough clinical examination, contrast computed tomography performed at the initial stage, and the current possibilities of interventional radiology are the keys to improving the results of treatment of acute mesenteric ischemia. The purpose of this paper is to refresh knowledge in the management of acute mesenteric ischemia and summarize the most up-to-date information on the diagnosis and treatment of this disease.

Keywords:

acute mesenteric ischemia – mesenteric arterial embolism – non-occlusive mesenteric ischemia – mesenteric venous thrombosis – occlusive mesenteric ischemia

Sources

Kärkkäinen JM. Acute mesenteric ischemia: A challenge for the acute care surgeon. Scandinavian Journal of Surgery 2021;(2)110:150–158. doi: 10.1177/14574969211007590.
Bala B, Catena F, Kashuk J, et al. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. World Journal of Emergency Surgery 2022;17(1):1–17. doi: 10.1186/ s13017-022-00443-x.
Luther B, Mamopoulos A, Lehmann C, et al. The ongoing challenge of acute mesenteric ischemia. Visc Med. 2018;34:217–223. doi: 10.1159/000490318.
Björck M, Koelemay M, Acosta S, et al. Editor’s choice – Management of the diseases of mesenteric arteries and veins: Clinical practice guidelines of the European Society of Vascular Surgery (ESVS). European Journal of Vascular and Endovascular Surgery 2017;53(4):460–510. doi: 10.1016/j. ejvs.2017.01.010.
Memet O, Zhang L, Shen J. Serological biomarkers for acute mesenteric ischemia. Ann Transl Med. 2019;7(16):394–394. doi: 10.21037/ATM.2019.07.51.
Amini A, Nagalli S. Bowel ischemia. StatPearls Publishing 2023.
Segovia FD, Ream S, Dang T, et al. COVID-19-associated superior mesenteric artery thrombosis and acute intestinal ischemia. Cureus 2022;14(8): e27722. doi: 10.7759/CUREUS.27722.
Overview of intestinal ischemia in adults UpToDate. https://www.uptodate.com/ contents/overview-of-intestinal-ischemia-in
Sayegh AS, Medina LG, La Riva A, et al. Superior mesenteric artery injury during robotic radical nephrectomy: Scenarios and management strategies. J Clin Med. 2023;12(2):427. doi: 10.3390/ JCM12020427.
Bala M, Kashuk J, Moore EE, et al. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2017;12(1). doi: 10.1186/S13017-017-0150-5.
Krška Z, Ulrych J. Mezenteriální ischémie. In Náhlé příhody břišní 2. Aktuální pohled na klasifikaci, diagnostiku a léčbu. 1st ed. Praha, We Make Media 2023:39–76.
Páral J. Akutní mezenteriální ischemie. Moderní diagnostika a léčba akutní ischemie střeva, 1. vydání. Praha, Grada Publishing 2012.
Kanasaki S. Furukawa A, Fumoto K, et al. Acute mesenteric ischemia: Multidetector CT findings and endo-vascular management. RadioGraphic 2018;38(3). doi: 10.1148/rg.2018170163.
Jain V, Huerta J. More on ‘No Gut Syndrome’: A case report. Int J Surg Case Rep. 2016;35–37. doi: 10.1016/J. IJSCR.2015.12.014.
Thomas JF, Jordan GL. Massive resection of small bowel and total colectomy: Use of reversed segment. Archives of Surgery 1965; 90(5):781–786. doi: 10.1001/archsurg.1965.01320110117019.
Kühn F, Schiergens TS, Klar E. Acute mesenteric ischemia. Visc Med. 2020;36:256–262. doi: 10.1159/000508739.

Labels

Surgery Orthopaedics Trauma surgery

Potřebujeme ještě všeobecnou chirurgii?

Blast syndrome – pathophysiology, diagnosis and treatment of blast injuries

Metastatic potential of T1a and T1b non-small cell lung cancer: analysis in the Czech population

An unusual case of gastrointestinal tract occlusion, Ladd’s syndrome and neuroendocrine tumour of the appendix in a 19-year-old female patient

Systemic toxic effects of Mesocain® in routine surgical practice upon iatrogenic overdose requiring cardiopulmonary resuscitation – case report

Strangulation ileus caused by malposition of the ureter

Article was published in

Perspectives in Surgery

2023 Issue 6