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[Management of acute intestinal arterial ischemia]
S Chabert1, J Porcheron, J G Balique
1Service de Chirurgie Générale, Hôpital de Bellevue, Saint-Etienne.
Abstract:
Acute mesenteric ischemia is an infrequent abdominal emergency. The 90% mortality of this affection is related to a delayed diagnosis. The mesenteric ischemia and the mesenteric infarction are two different pathologic stages characterized by two different treatment and prognosis. Superior mesenteric artery embolism is the most frequent cause of mesenteric ischemia. According a difficult clinical diagnosis and the necessity of an early diagnosis we suggest an aggressive attitude. All the patients presenting risk factors and an abdominal pain must have a mesenteric angiography. The purpose of the angiography is diagnostic and therapeutic. The aim of surgery in case of mesenteric ischemia is to restore a normal vascularisation. In spite of this attitude the prognosis of this affection remain poor.
Insights
Acute mesenteric ischemia, a rare emergency, has a 90% mortality due to delayed diagnosis. Early diagnosis via aggressive mesenteric angiography is crucial for timely intervention and improved outcomes in high-risk patients.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Emergency Medicine
Context:
- Acute mesenteric ischemia is a rare but life-threatening abdominal emergency.
- Delayed diagnosis significantly contributes to the high mortality rate (90%).
- Mesenteric ischemia and infarction represent distinct pathological stages with different treatment strategies and prognoses.
Purpose:
- To emphasize the critical need for early diagnosis in acute mesenteric ischemia.
- To advocate for an aggressive diagnostic and therapeutic approach.
- To highlight the role of mesenteric angiography in both diagnosis and treatment.
Summary:
- Superior mesenteric artery embolism is the most common cause of acute mesenteric ischemia.
- Patients with risk factors and abdominal pain warrant immediate mesenteric angiography.
- The primary surgical goal is to restore vascular supply, though prognosis remains poor.
Impact:
- Promoting earlier diagnosis and intervention for acute mesenteric ischemia.
- Improving patient outcomes through timely and aggressive management strategies.
- Highlighting the diagnostic and therapeutic utility of mesenteric angiography in this critical condition.