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Acute mesenteric ischemia

S M Sachs, J H Morton, S I Schwartz

    Surgery
    |October 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Acute mesenteric ischemia has a high mortality rate (65%), with outcomes heavily dependent on the cause. Early diagnosis and appropriate treatment, guided by the specific etiology, are crucial for improving patient survival in mesenteric ischemia.

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    Area of Science:

    • Gastroenterology
    • Vascular Surgery
    • Emergency Medicine

    Background:

    • Acute mesenteric ischemia (AMI) is a critical surgical emergency with high mortality.
    • Prognosis and treatment strategies for AMI vary significantly based on its underlying cause.

    Purpose of the Study:

    • To analyze the outcomes of 49 patients treated for AMI over 15 years.
    • To correlate diagnostic criteria, therapeutic interventions, and prognostic factors with the specific etiology of AMI.

    Main Methods:

    • Retrospective review of 49 patients with AMI.
    • Analysis of mortality rates, presenting symptoms (peritoneal signs), serum enzyme levels (SGOT, LDH, CPK), and diagnostic procedures (angiography).
    • Evaluation of the effectiveness of reexploration and resectional therapy.

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    Main Results:

    • Overall mortality rate was 65%, with survival significantly influenced by etiology (e.g., 0% for arterial thrombosis, 100% for arterial vasculitis).
    • Elevated serum enzymes indicated nonocclusive ischemia or thrombosis, while normal levels suggested arterial embolization.
    • Angiography proved diagnostic for suspected embolization and nonocclusive ischemia; reexploration had a low survival benefit (17.7%).

    Conclusions:

    • The etiology of acute mesenteric ischemia is a critical determinant of patient prognosis.
    • Diagnostic accuracy can be improved with increased use of angiography, particularly for suspected embolization.
    • While reexploration offers limited survival benefit, specific cases of venous thrombosis or arterial embolization may benefit from resectional therapy.