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Updated: Dec 28, 2025
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Techniques for intraoperative evaluation of bowel viability in mesenteric ischemia: A review
Mitchell G Bryski1, Lydia G Frenzel Sulyok1, Lewis Kaplan1
1University of Pennsylvania, Department of Surgery, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Abstract:
Acute mesenteric ischemia (AMI) is a deadly and common surgical emergency. While several imaging modalities aid in the diagnosis of AMI preoperatively, there are limited intraoperative tools for surgeon decision making regarding bowel viability. Here we offer a review of the utility and limitations of the many extensively studied techniques. We classify each of these modalities into three hallmarks of healthy bowel: oxygenation, myoelectric activity and perfusion. Finally, we offer a brief discussion of emerging and promising techniques to assist surgeons in intraoperative decision making for patients with mesenteric ischemia.
Insights
Diagnosing acute mesenteric ischemia (AMI) intraoperatively remains challenging. This review examines current and emerging techniques for assessing bowel viability, focusing on oxygenation, myoelectric activity, and perfusion to aid surgical decisions.
Area of Science:
- Surgery
- Gastroenterology
- Vascular Surgery
Background:
- Acute mesenteric ischemia (AMI) is a critical surgical emergency with high mortality.
- Preoperative diagnosis relies on imaging, but intraoperative assessment of bowel viability is limited.
- Surgeons need reliable tools to guide decision-making during surgery for AMI.
Purpose of the Study:
- To review the utility and limitations of intraoperative techniques for assessing bowel viability in AMI.
- To classify existing modalities based on physiological hallmarks of healthy bowel.
- To discuss emerging technologies for improved intraoperative assessment.
Main Methods:
- Literature review of extensively studied intraoperative techniques for AMI.
- Classification of modalities based on bowel oxygenation, myoelectric activity, and perfusion.
- Discussion of emerging and promising diagnostic tools.
Main Results:
- Current intraoperative tools for assessing bowel viability in AMI have limitations.
- Techniques can be categorized by their assessment of oxygenation, myoelectric activity, or perfusion.
- Several promising new techniques are under development.
Conclusions:
- Intraoperative assessment of bowel viability in AMI requires further advancement.
- Categorizing techniques by physiological hallmarks aids understanding.
- Emerging technologies hold promise for improving surgical decision-making in AMI.
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