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Acute mesenteric ischaemia.

I D Vellar, J C Doyle

    The Australian and New Zealand Journal of Surgery
    |February 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    Acute mesenteric ischemia has a high mortality rate, especially with superior mesenteric artery thrombosis (97%). Early diagnosis via mesenteric angiography is crucial for timely intervention and improved patient outcomes.

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    Area of Science:

    • Gastroenterology
    • Vascular Surgery
    • Emergency Medicine

    Background:

    • Acute mesenteric ischemia presents a significant diagnostic and therapeutic challenge.
    • Review of 17 years of experience at St Vincent's Hospital, Melbourne, highlights persistently high mortality rates.

    Purpose of the Study:

    • To analyze the outcomes of acute mesenteric ischemia over a 17-year period.
    • To identify factors contributing to high mortality and emphasize the need for early diagnosis.

    Main Methods:

    • Retrospective review of patient data for acute mesenteric ischemia.
    • Analysis of mortality rates based on the cause of ischemia (arterial thrombosis, embolic occlusion, venous thrombosis, non-occlusive).

    Main Results:

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    • Overall mortality for acute mesenteric ischemia remains high.
    • Superior mesenteric artery thrombosis had a 97% mortality rate.
    • Embolic occlusion (66%), superior mesenteric vein thrombosis (60%), and non-occlusive ischemia (66%) also showed high mortality.

    Conclusions:

    • Delay in diagnosis is a primary driver of mortality in acute mesenteric ischemia.
    • Mesenteric angiography is essential for early diagnosis and guiding treatment (surgery for occlusive, supportive/papaverine for non-occlusive).
    • Development of simple, non-invasive tests is urgently needed to differentiate mesenteric ischemia from other acute abdominal conditions.