[Color Doppler ultrasound in acute mesenteric ischemia: 2 case reports]

Area of Science:

• Vascular Surgery
• Diagnostic Imaging
• Gastroenterology

Background:

• Acute mesenteric insufficiency presents diagnostic challenges due to non-specific early symptoms and inconclusive laboratory/radiographic findings.
• Timely diagnosis is crucial for reducing the high mortality associated with mesenteric ischemia.
• Conventional ultrasound has limitations in accurately diagnosing visceral ischemia.

Observation:

• Two female patients with atrial fibrillation presented with abdominal pain, leukocytosis, and hyperamylasemia.
• Color Doppler ultrasound was performed 12 hours after admission for both patients.
• Findings included a "stop" of superior mesenteric artery enhancement in one patient and absence of enhancement in the other.

Findings:

• Echo-doppler ultrasound demonstrated abnormalities in superior mesenteric artery enhancement.
• These findings suggest potential utility of echo-doppler in diagnosing visceral ischemia.
• The technique may aid in identifying patients requiring further investigation, such as angiography.

Implications:

• Echo-doppler ultrasound offers improved accuracy over conventional methods for diagnosing visceral ischemia.
• Early identification of mesenteric ischemia can lead to prompt intervention and potentially lower mortality rates.
• This imaging modality may refine patient selection for angiography in suspected cases of mesenteric insufficiency.