Related Experiment Video

Updated: Sep 15, 2025

Multimodality Diagnosis of Mesenteric Ischemia
05:07

Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

732

Current Approaches to Diagnosis and Management of Acute Mesenteric Ischaemia: A Scoping Review

Liam Costello1, William P Duggan2, Michael Flanagan2

  • 1Department of Surgery, Tallaght University Hospital, Dublin, Ireland, costelli@tcd.ie.

Digestive Surgery
|July 15, 2025
PubMed
Abstract

Insights

Acute mesenteric ischaemia (AMI) management has improved with endovascular interventions, showing lower mortality and shorter hospital stays compared to open surgery. Timely diagnosis is crucial for better patient outcomes in this critical condition.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Gastroenterology

Background:

  • Acute mesenteric ischaemia (AMI) presents a significant mortality risk, often exceeding 50%.
  • Current diagnostic and management strategies require evaluation.
  • Comparison between endovascular and open surgical approaches is essential.

Purpose of the Study:

  • To conduct a scoping review of diagnostic and management strategies for AMI.
  • To compare endovascular versus open surgical interventions for AMI.
  • To identify factors influencing patient outcomes in AMI.

Main Methods:

  • Systematic literature search (2005-2024) across OVID MEDLINE, Embase, and Web of Science.
  • Inclusion of English-language studies on AMI, following Arksey and O'Malley's framework.
  • Extraction of data on diagnostics, mortality, hospital/ICU stay, and surgical outcomes from 39 studies (20,991 patients).

Main Results:

  • CT angiography is the predominant diagnostic tool, with delays averaging 13.9 to 48 hours.
  • Endovascular interventions showed lower 30-day mortality (0%-53.8%) compared to open surgery (21%-81%).
  • Endovascular management resulted in shorter hospital (5-15.35 vs. 5.7-27.26 days) and ICU stays (0-5.35 vs. 2-13 days), with reduced rates of bowel resection and re-laparotomy.

Conclusions:

  • Endovascular management is linked to superior outcomes in AMI, including decreased mortality and shorter hospitalizations.
  • Prompt diagnosis and appropriate patient selection are paramount for effective AMI treatment.
  • A multidisciplinary approach is vital, necessitating further prospective research to standardize treatment protocols.
Keywords:
Bowel resectionEndovascularMesenteric ischaemiaOpen revascularisation

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