A clinical approach to acute mesenteric ischemia

Area of Science:

• Critical Care Medicine
• Vascular Surgery
• Gastroenterology

Background:

• Acute mesenteric ischemia (AMI) is a critical condition in critically ill patients.
• Current evidence suggests a multidisciplinary approach can improve patient outcomes.
• Pathophysiology, diagnosis, and management strategies are continually evolving.

Purpose of the Study:

• To review current evidence on the pathophysiology, definition, diagnosis, and management of AMI in critically ill patients.
• To highlight recent advancements and challenges in treating AMI.
• To emphasize the importance of a multidisciplinary approach.

Main Methods:

• Review of recent studies and clinical evidence.
• Focus on diagnostic modalities, including triphasic CT-angiography.
• Discussion of endovascular, surgical, and medical management strategies.

Main Results:

• A multidisciplinary approach in specialized centers improves AMI outcomes.
• Triphasic CT-angiography is crucial for early diagnosis.
• Nonocclusive mesenteric ischemia and early mucosal injury detection remain challenging.
• Supportive medical management and nutritional support are vital.

Conclusions:

• Clinical suspicion combined with tri-phasic CT-angiography is essential for AMI diagnosis.
• Multidisciplinary team efforts are critical for optimizing patient outcomes.
• Further research is needed for early biomarkers and improved management of nonocclusive AMI.