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Updated: Nov 5, 2025
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Outcomes of Management of Patients with Acute Mesenteric Ischemia: A Prospective Study
Meghraj Kundan1, Hethu Chebrolu1, Chetan Muniswamppa1
1Department of General Surgery, V.M.M.C and Safdarjung Hospital, New Delhi, India.
Introduction:
Acute mesenteric ischemia (AMI) is the sudden onset of small intestinal hypoperfusion, which can be due to reduction or cessation of arterial inflow. It can be embolic or thrombotic. AMI is a potentially fatal vascular emergency, with overall mortality of 60%-80%. The present study was designed to study presentation, risk factors, and various outcomes of AMI patients, who were treated in the tertiary hospital.
Methodology:
All patients with features suggestive of AMI were taken in study. All patients underwent explorative laparotomy with exteriorization of bowel after initial resuscitation. Postoperatively, refeeding enteroclysis was done.
Observation And Results:
The total mortality rate was 62.50%. In patients with functional bowel length of 1 foot, 90.90% patients died. In patients with functional bowel length of 5-6 feet, only 12.50% died. It was observed that the mortality rate was more in the age group of 50-59 years with functional bowel length of 1 foot or <1 foot. Refeeding enteroclysis is an effective technique to use distal bowel. Contrast-enhanced computed tomography of the abdomen more suggestive of this pathology.
Conclusions:
A strong clinical suspicion and an aggressive approach should be considered in dealing with this condition because the outcome mainly depends on rapid diagnosis and treatment. With understanding of the pathogenesis of AMI and the better utilization of available radiological investigations, an improved outcome can be achieved. Mortality rates with refeeding enteroclysis are comparable with that of bowel anastomosis. This condition needs future research.
Insights
Acute mesenteric ischemia (AMI) is a serious condition with high mortality. Shorter functional bowel length significantly increases the risk of death, highlighting the need for rapid diagnosis and treatment.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Emergency Medicine
Background:
- Acute mesenteric ischemia (AMI) is a critical vascular emergency caused by reduced blood flow to the small intestine.
- It has a high mortality rate, ranging from 60% to 80%.
Purpose of the Study:
- To investigate the presentation, risk factors, and outcomes of patients with AMI treated at a tertiary hospital.
- To evaluate the effectiveness of refeeding enteroclysis and contrast-enhanced computed tomography (CECT) in managing AMI.
Main Methods:
- Patients with suspected AMI underwent explorative laparotomy and bowel exteriorization.
- Postoperative management included refeeding enteroclysis.
- Contrast-enhanced computed tomography (CECT) of the abdomen was utilized for diagnosis.
Main Results:
- The overall mortality rate was 62.50%.
- Patients with functional bowel length of 1 foot or less had a 90.90% mortality rate, compared to 12.50% for those with 5-6 feet.
- Higher mortality was observed in the 50-59 age group with limited functional bowel length.
Conclusions:
- Early clinical suspicion and aggressive management are crucial for improving AMI outcomes.
- Understanding AMI pathogenesis and utilizing radiological investigations like CECT can enhance patient outcomes.
- Refeeding enteroclysis demonstrates comparable mortality rates to bowel anastomosis and is effective for distal bowel management.
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