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[Emergency diagnostic imaging in mesenteric ischemia].

C Düber1, M Wüstner, S J Diehl

  • 1Institut für Klinische Radiologie, Universitätsklinikum Mannheim, Fakultät für Klinische Medizin Mannheim, Universität Heidelberg. shristoph.dueber@rad.ma.uni-heidelberg.de

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|May 16, 2003
PubMed
Summary

Diagnostic imaging for acute mesenteric ischemia begins with ultrasound, followed by CT scans for detailed vessel and bowel assessment. Angiography is the gold standard when CT is unavailable.

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Area of Science:

  • Radiology
  • Gastroenterology
  • Vascular Surgery

Context:

  • Acute mesenteric ischemia (AMI) is a surgical emergency requiring prompt diagnosis and intervention.
  • Diagnostic imaging plays a critical role in the evaluation of suspected AMI.
  • Timely imaging is essential to differentiate AMI from other acute abdominal conditions.

Purpose:

  • To review the diagnostic imaging modalities for acute mesenteric ischemia.
  • To compare the effectiveness of ultrasound, CT, MRI, and angiography in diagnosing AMI.
  • To highlight the role of imaging in guiding treatment decisions for AMI.

Summary:

  • Abdominal ultrasound with duplex sonography is the initial imaging test for suspected AMI, enabling rapid treatment initiation if positive.
  • Spiral CT, particularly multislice, offers detailed visualization of mesenteric vessels and bowel changes, aiding pathological diagnosis.

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  • While MRI shows comparable accuracy to CT, its limited availability restricts its emergency use; catheter angiography remains the gold standard for mesenteric vasculature when CT is not available.

    • Impact:

    • Optimizing imaging strategies can lead to earlier diagnosis and improved patient outcomes in acute mesenteric ischemia.
    • Understanding the strengths and limitations of each imaging modality allows for tailored diagnostic pathways.
    • This review provides a comprehensive overview for clinicians managing patients with suspected acute mesenteric ischemia.