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Updated: Aug 29, 2025
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Case report: Early detection of mesenteric ischemia by intravital microscopy in a patient with septic shock
Janina Praxenthaler1,2, Carmen Kirchner3, Elke Schwier1
1Department of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Klinikum Herford, Ruhr University Bochum, Herford, Germany.
Abstract:
Gut ischemia is a frequent but underdiagnosed complication, especially in critically ill intensive care patients, and represents a special diagnostic challenge that can only be solved in an interdisciplinary manner. We report a case of a 54-year-old woman with acute mesenteric ischemia (AMI) as a cause of septic shock diagnosed by intravital microscopy (IVM) 2 days before visible necrotic changes in a multimodality approach. We show that intravital microscopy can be a serious alternative for the early diagnosis of mesenteric ischemia in the hands of the skilled. We use this case to discuss the value and clinical perspective of IVM in the intensive care setting.
Insights
Early diagnosis of gut ischemia in critically ill patients is challenging. Intravital microscopy (IVM) offers a promising method for detecting acute mesenteric ischemia (AMI) before irreversible damage occurs.
Area of Science:
- Gastroenterology
- Critical Care Medicine
- Surgical Innovation
Background:
- Gut ischemia is a common yet underdiagnosed complication in intensive care units.
- Diagnosing acute mesenteric ischemia (AMI) presents significant challenges, often requiring interdisciplinary collaboration.
Observation:
- A 54-year-old woman presented with septic shock attributed to AMI.
- Intravital microscopy (IVM) facilitated diagnosis 2 days prior to the appearance of necrotic changes.
Findings:
- IVM proved effective for the early detection of mesenteric ischemia.
- This case highlights the potential of IVM in critical care settings.
Implications:
- Skilled application of IVM can significantly improve early diagnosis of AMI.
- IVM represents a valuable tool for managing critically ill patients with suspected gut ischemia.
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