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Multimodality Diagnosis of Mesenteric Ischemia
05:07

Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

1.2K

Clinical management of chronic mesenteric ischemia

Louisa Jd van Dijk1,2, Desirée van Noord1,3, Annemarie C de Vries1

  • 1Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

United European Gastroenterology Journal
|May 14, 2019
PubMed

Insights

Chronic mesenteric ischemia (CMI) is a condition of reduced blood flow to the gastrointestinal tract. Early diagnosis and multidisciplinary consensus are key for effective treatment, preferably endovascular revascularization.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Radiology

Background:

  • Chronic mesenteric ischemia (CMI) results from inadequate blood supply to the gastrointestinal tract, typically due to atherosclerotic stenosis of mesenteric arteries.
  • Classic symptoms include postprandial abdominal pain and weight loss, but atypical presentations like discomfort, nausea, vomiting, diarrhea, or constipation can occur.

Purpose of the Study:

  • To provide an overview of the clinical management of chronic mesenteric ischemia (CMI).
  • To emphasize the importance of early diagnosis and multidisciplinary consensus for optimal patient selection and treatment.

Main Methods:

  • Review of clinical management strategies for CMI.
  • Diagnosis relies on a triad of clinical symptoms, radiological evaluation of mesenteric vasculature, and functional assessment of mucosal ischemia.
  • Multidisciplinary consensus is crucial for accurate diagnosis and treatment planning.

Main Results:

  • Patients with atherosclerotic CMI, whether single-vessel or multi-vessel, are best treated with endovascular revascularization.
  • Timely diagnosis and treatment of CMI can improve quality of life and prevent acute-on-chronic events.

Conclusions:

  • Effective management of CMI requires a comprehensive approach integrating clinical, radiological, and functional assessments.
  • Endovascular revascularization is the preferred treatment for selected patients with atherosclerotic CMI.

Keywords:
Chronic mesenteric ischemiaatherosclerosiscomputed tomography angiographyendovascular therapymedian arcuate ligament syndrome

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