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Acute intestinal ischemia and infarction.

David A Tendler¹

¹Gastroenterology Division and Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.

Seminars in Gastrointestinal Disease

|August 2, 2003

Summary

Acute intestinal ischemia is a serious condition caused by reduced blood flow to the bowel. Prompt diagnosis and intervention are crucial for survival, especially in acute mesenteric ischemia cases.

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Area of Science:

Gastroenterology
Vascular Surgery
Emergency Medicine

Background:

Acute intestinal ischemia is a critical medical emergency characterized by sudden decreased blood flow to the intestines.
It can affect the small intestine or colon, potentially leading to bowel infarction, sepsis, and mortality.
Prompt diagnosis and management are essential due to the high mortality rates associated with this condition.

Purpose of the Study:

To review the pathophysiology, clinical features, diagnostic approaches, and therapeutic strategies for acute intestinal ischemia.
To differentiate between acute mesenteric ischemia and acute colonic ischemia.
To emphasize the importance of early detection and intervention for improved patient outcomes.

Main Methods:

Review of existing literature on acute intestinal ischemia.
Analysis of pathophysiology, clinical presentations, diagnostic modalities, and treatment options.
Comparison of outcomes for acute mesenteric ischemia versus acute colonic ischemia.

Main Results:

Acute mesenteric ischemia, often due to vascular occlusion, has a high mortality rate (around 70%) but can be improved with early diagnosis, angiography, and surgery.
Acute colonic ischemia, typically a mismatch between blood flow and metabolic demand, is often reversible with lower mortality rates.
Timely diagnostic consideration, angiography, and surgical intervention are key for improving survival in acute mesenteric ischemia.

Conclusions:

Acute intestinal ischemia requires urgent attention, with distinct characteristics and prognoses for mesenteric and colonic forms.
Early diagnostic consideration, timely angiography, and appropriate surgical intervention significantly impact survival rates in acute mesenteric ischemia.
Understanding the pathophysiology and clinical features is vital for effective management and improved outcomes in patients with acute intestinal ischemia.

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