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Multimodality Diagnosis of Mesenteric Ischemia
05:07

Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors

S Acosta1, M Ogren, N-H Sternby

  • 1Department of Vascular Diseases, Malmö University Hospital, Malmö, Sweden. stefan.acosta@telia.com

Journal of Internal Medicine
|February 16, 2006
PubMed
Abstract

Insights

Nonocclusive mesenteric ischemia (NOMI) is a serious condition, with fatal cases increasing in the elderly. Heart failure is a primary cause, alongside other risk factors like atrial fibrillation and recent surgery.

Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Pathology

Background:

  • Nonocclusive mesenteric ischemia (NOMI) and transmural intestinal infarction are severe conditions with high mortality.
  • Estimating the incidence and causes of visceral organ infarction in NOMI patients is crucial for improving outcomes.

Purpose of the Study:

  • To determine the incidence and extent of visceral organ infarction in autopsy-verified NOMI cases.
  • To identify potential causes and risk factors associated with fatal NOMI.

Main Methods:

  • A population-based study utilizing autopsy data from Malmö, Sweden (1970-1982).
  • Analysis of 23,446 clinical and 7,569 forensic autopsy protocols.
  • A nested case-control study matched for age, gender, and death year to identify NOMI risk factors.

Main Results:

  • Overall incidence of fatal NOMI was 2.0/100,000 person-years, rising with age.
  • Superior mesenteric artery (SMA) stenosis was associated with older age and coeliac trunk stenosis.
  • Liver, spleen, or kidney infarction occurred in 20% of patients; fatal cardiac failure, atrial fibrillation, and recent surgery were significant risk factors.

Conclusions:

  • Fatal heart failure is the leading cause of intestinal hypoperfusion in NOMI.
  • SMA stenosis, coeliac trunk stenosis, atrial fibrillation, and recent surgery are significant contributing factors.
  • Interdisciplinary collaboration is essential for improving NOMI patient prognosis.

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