Acute Mesenteric Ischaemia (AMI) is an uncommon vascular emergency where the diagnosis is often difficult and overlooked and delay in diagnosis results in a grave outcome. Although extravascular events like intussusception, volvulus, strangulated hernia and adhesive obstruction in neglected cases can result intestinal gangrene, this contribution will be limited to acute mesenteric ischaemia as a primary event. AMI consists of four pathologic processes (arterial thrombosis, arterial embolism, Non Occlusive Mesenteric Ischaemia (NOMI) and mesenteric venous thrombosis (MVT)) with similar clinical presentation and one potentially fatal pathological endpoint- intestinal gangrene. The clinical setting and the patient's risk profile often give the clue to the etiological process while the presentation is dominated by severe unrelenting abdominal pain out of proportion to the physical findings. The key to the successful management depends on the surgeon's ability to suspect the diagnosis, pursue appropriate investigations and institute aggressive treatment. The mortality remains high due to difficulty and delay in the diagnosis.
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http://dx.doi.org/10.1080/00015458.2005.11679734 | DOI Listing |
Background: Pneumatosis intestinalis on CT presents a diagnostic dilemma, because it could reflect bowel ischemia or benign finding.
Purpose: To determine radiological and clinical features that can predict bowel ischemia in patients with pneumatosis intestinalis on CT.
Materials And Methods: Patients with "pneumatosis" in abdominal CT reports performed between 1/1/2002 and 12/31/2018 were retrospectively included.
Drug Des Devel Ther
January 2025
Department of Pediatric Surgery, Faculty of Medicine, Gazi University, Yenimahalle, Ankara, Turkey.
Background: Intestinal ischemia/reperfusion (I/R) injury can occur in a wide variety of diseases and surgeries. If necessary, the blood flow should be restored, including re-anastomosis by removing the intestines with impaired circulation. In this process, anastomotic strength is as important as inflammatory responses and oxidative stress.
View Article and Find Full Text PDFAnn Vasc Surg
January 2025
University of Sao Paulo (USP), Division of Vascular Surgery, Department of Medicine, Sao Paulo, Brazil.
Introduction: The main treatment for Chronic Mesenteric Ischemia (CMI) is revascularization, typically achieved through stent angioplasty of the superior mesenteric artery, and in certain cases, the celiac trunk. However, long-term outcomes using bare-metal stents have been less than satisfactory. Therefore, we aimed to compare the performance of covered stents (CS) versus bare-metal stents (BMS) in patients treated for CMI.
View Article and Find Full Text PDFAnn Vasc Surg
January 2025
Institute of Cardiac and Aortic Disorders, SRM Institutes for Medical Science (SIMS Hospitals), Chennai, India.
Background: Nonocclusive mesenteric ischemia (NOMI), a subtype of acute mesenteric ischemia, is primarily caused by mesenteric arterial vasoconstriction and decreased vascular resistance, leading to impaired intestinal perfusion.Commonly observed after cardiac surgery, NOMI affects older patients with cardiovascular or systemic diseases, accounting for 20-30% of acute mesenteric ischemia cases with a mortality rate of ∼50%. This review explores NOMI's pathophysiology, clinical implications in aortic dissection, and the unmet needs in diagnosis and management, emphasizing its prognostic significance.
View Article and Find Full Text PDFJ Acad Consult Liaison Psychiatry
January 2025
Department of Psychiatry, UMass Chan Medical School- Baystate, Springfield, MA. Electronic address:
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