Acute Mesenteric Ischemia
Keywords:
Acute mesenteric ischemia, Bowel gangrene, AnticoagulantAbstract
Acute mesenteric ischemia is a condition in which there is a sudden lack of blood flow to the intestines, leading to bowel gangrene, morbidity and mortality. The most common causes include mesenteric arterial embolism, thrombosis, mesenteric venous thrombosis, and non-occlusive mesenteric ischemia. Diagnosis is typically done using computed tomography angiography (CTA), which helps determine the location of pathology and the extent of the ischemia included the complication of mesenteric ischemia. Treatment involves medications to prevent clot propagation and preserve collateral vessel by anticoagulant, fluid replacement, and urgency surgical intervention to restore blood flow and reduce the risk of intestinal loss and mortality. Therefore, physicians and surgeons should have knowledge of both diagnosis and initial treatment options, leading to prompt surgical decision-making for rapid treatment and decreased patient mortality.
References
Acosta S. Mesenteric ischemia. Curr Opin Crit Care. 2015;21(2):171-8.
Oldenburg WA, Lau LL, Rodenberg TJ, Edmonds HJ, Burger CD. Acute mesenteric ischemia: a clinical review. Arch Intern Med. 2004;164(10):1054-62.
Clair DG, Beach JM. Mesenteric Ischemia. N Engl J Med. 2016;374(10):959-68.
Duran M, Pohl E, Grabitz K, Schelzig H, Sagban TA, Simon F. The importance of open emergency surgery in the treatment of acute mesenteric ischemia. World J Emerg Surg. 2015;10(1):45.
Douard R, Chevallier JM, Delmas V, Cugnenc PH. Clinical interest of digestive arterial trunk anastomoses. Surg Radiol Anat. 2006;28(3):219-27.
Björck M, Koelemay M, Acosta S, Bastos Goncalves F, Kölbel T, Kolkman JJ, et al. Editor's Choice - Management of the Diseases of Mesenteric Arteries and Veins: Clinical Practice Guidelines of the European Society of Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2017;53(4):460-510.
Schoots IG, Koffeman GI, Legemate DA, Levi M, van Gulik TM. Systematic review of survival after acute mesenteric ischaemia according to disease aetiology. Br J Surg. 2004;91(1):17-27.
Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M. Clinical implications for the management of acute thromboembolic occlusion of the superior mesenteric artery: autopsy findings in 213 patients. Ann Surg. 2005;241(3):516-22.
Kirkpatrick AW, Roberts DJ, De Waele J, Jaeschke R, Malbrain MLNG, De Keulenaer B, et al. Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Medicine. 2013;39(7):1190-206.
Kolkman JJ, Mensink PBF. Non-occlusive mesenteric ischaemia: a common disorder in gastroenterology and intensive care. Best Pract Res Clin Gastroenterol. 2003;17(3):457-73.
Cohn DM, Roshani S, Middeldorp S. Thrombophilia and venous thromboembolism: implications for testing. Semin Thromb Hemost. 2007;33(6):573-81.
Matsumoto S, Sekine K, Funaoka H, Yamazaki M, Shimizu M, Hayashida K, et al. Diagnostic performance of plasma biomarkers in patients with acute intestinal ischaemia. Br J Surg. 2014;101(3):232-8.
Block T, Nilsson TK, Björck M, Acosta S. Diagnostic accuracy of plasma biomarkers for intestinal ischaemia. Scand J Clin Lab Invest. 2008;68(3):242-8.
Akyildiz H, Akcan A, Oztürk A, Sozuer E, Kucuk C, Karahan I. The correlation of the D-dimer test and biphasic computed tomography with mesenteric computed tomography angiography in the diagnosis of acute mesenteric ischemia. Am J Surg. 2009;197(4):429-33.
Nuzzo A, Maggiori L, Ronot M, Becq A, Plessier A, Gault N, et al. Predictive Factors of Intestinal Necrosis in Acute Mesenteric Ischemia: Prospective Study from an Intestinal Stroke Center. Am J Gastroenterol. 2017;112(4):597-605.
Oliva IB, Davarpanah AH, Rybicki FJ, Desjardins B, Flamm SD, Francois CJ, et al. ACR Appropriateness Criteria ® imaging of mesenteric ischemia. Abdom Imaging. 2013;38(4):714-9.
Bala M, Catena F, Kashuk J, De Simone B, Gomes CA, Weber D, et al. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2022;17(1):54.
Wadman M, Block T, Ekberg O, Syk I, Elmståhl S, Acosta S. Impact of MDCT with intravenous contrast on the survival in patients with acute superior mesenteric artery occlusion. Emerg Radiol. 2010;17(3):171-8.
Klar E, Rahmanian PB, Bücker A, Hauenstein K, Jauch KW, Luther B. Acute mesenteric ischemia: a vascular emergency. Dtsch Arztebl Int. 2012;109(14):249-56.
Emile SH, Khan SM, Barsoum SH. Predictors of bowel necrosis in patients with acute mesenteric ischemia: systematic review and meta-analysis. Updates Surg. 2021;73(1):47-57.
Collins JD. MR Imaging of the Mesenteric Vasculature. Radiol Clin North Am. 2020;58(4):797-813.
Corcos O, Nuzzo A. Gastro-intestinal vascular emergencies. Best Pract Res Clin Gastroenterol. 2013;27(5):709-25.
Helmerhorst HJ, Schultz MJ, van der Voort PH, de Jonge E, van Westerloo DJ. Bench-to-bedside review: the effects of hyperoxia during critical illness. Crit Care. 2015;19(1):284.
A Global Declaration on Appropriate Use of Antimicrobial Agents across the Surgical Pathway. Surg Infect (Larchmt). 2017;18(8):846-53.
Sise MJ. Mesenteric ischemia: the whole spectrum. Scand J Surg. 2010;99(2):106-10.
Chou EL, Wang LJ, McLellan RM, Feldman ZM, Latz CA, LaMuraglia GM, et al. Evolution in the Presentation, Treatment, and Outcomes of Patients with Acute Mesenteric Ischemia. Ann Vasc Surg. 2021;74:53-62.
Malgor RD, Oderich GS, McKusick MA, Misra S, Kalra M, Duncan AA, et al. Results of single- and two-vessel mesenteric artery stents for chronic mesenteric ischemia. Ann Vasc Surg. 2010;24(8):1094-101.
Steinmetz E, Tatou E, Favier-Blavoux C, Bouchot O, Cognet F, Cercueil JP, et al. Endovascular treatment as first choice in chronic intestinal ischemia. Ann Vasc Surg. 2002;16(6):693-9.
Anton N Sidawy M, MPH and Bruce A Perler, MD, MBA. Rutherford's Vascular Surgery and Endovascular Therapy 10th edition2022.
Acosta S, Sonesson B, Resch T. Endovascular Therapeutic Approaches for Acute Superior Mesenteric Artery Occlusion. Cardiovasc Intervent Radiol. 2009;32(5):896-905.
Kärkkäinen JM, Lehtimäki TT, Saari P, Hartikainen J, Rantanen T, Paajanen H, et al. Endovascular Therapy as a Primary Revascularization Modality in Acute Mesenteric Ischemia. Cardiovasc Intervent Radiol. 2015;38(5):1119-29.
Dias NV, Acosta S, Resch T, Sonesson B, Alhadad A, Malina M, et al. Mid-term outcome of endovascular revascularization for chronic mesenteric ischaemia. Br J Surg. 2010;97(2):195-201.
Arthurs ZM, Titus J, Bannazadeh M, Eagleton MJ, Srivastava S, Sarac TP, et al. A comparison of endovascular revascularization with traditional therapy for the treatment of acute mesenteric ischemia. J Vasc Surg. 2011;53(3):698-704; discussion -5.
Block TA, Acosta S, Björck M. Endovascular and open surgery for acute occlusion of the superior mesenteric artery. J Vasc Surg. 2010;52(4):959-66.
Beaulieu RJ, Arnaoutakis KD, Abularrage CJ, Efron DT, Schneider E, Black JH, 3rd. Comparison of open and endovascular treatment of acute mesenteric ischemia. J Vasc Surg. 2014;59(1):159-64.
Bulkley GB, Zuidema GD, Hamilton SR, O'Mara CS, Klacsmann PG, Horn SD. Intraoperative Determination of Small Intestinal Viability following Ischemic Injury: A Prospective, Controlled Trial of Two Adjuvant Methods (Doppler and Fluorescein) Compared with Standard Clinical Judgment. Ann Surg. 1981;193(5):628-37.
Oderich GS, Macedo R, Stone DH, Woo EY, Panneton JM, Resch T, et al. Multicenter study of retrograde open mesenteric artery stenting through laparotomy for treatment of acute and chronic mesenteric ischemia. J Vasc Surg. 2018;68(2):470-80.e1.
Park WM, Gloviczki P, Cherry KJ, Jr., Hallett JW, Jr., Bower TC, Panneton JM, et al. Contemporary management of acute mesenteric ischemia: Factors associated with survival. J Vasc Surg. 2002;35(3):445-52.
Salim S, Ekberg O, Elf J, Zarrouk M, Gottsäter A, Acosta S. Evaluation of direct oral anticoagulants and vitamin K antagonists in mesenteric venous thrombosis. Phlebology. 2019;34(3):171-8.
Rhee RY, Gloviczki P, Mendonca CT, Petterson TM, Serry RD, Sarr MG, et al. Mesenteric venous thrombosis: still a lethal disease in the 1990s. J Vasc Surg. 1994;20(5):688-97.
Yang S, Fan X, Ding W, Liu B, Meng J, Xu D, et al. Multidisciplinary Stepwise Management Strategy for Acute Superior Mesenteric Venous Thrombosis: An Intestinal Stroke Center Experience. Thromb Res. 2015;135(1):36-45.
Sastry P, Hardman G, Page A, Parker R, Goddard M, Large S, et al. Mesenteric ischaemia following cardiac surgery: the influence of intraoperative perfusion parameters. Interact Cardiovasc Thorac Surg. 2014;19(3):419-24.
Mitsuyoshi A, Obama K, Shinkura N, Ito T, Zaima M. Survival in nonocclusive mesenteric ischemia: early diagnosis by multidetector row computed tomography and early treatment with continuous intravenous high-dose prostaglandin E(1). Ann Surg. 2007;246(2):229-35.
Takiguchi T, Nakajima M, Ohbe H, Sasabuchi Y, Matsui H, Fushimi K, et al. Vasodilator Therapy and Mortality in Nonocclusive Mesenteric Ischemia: A Nationwide Observational Study. Crit Care Med. 2020;48(5):e356-61.
Tilsed JVT, Casamassima A, Kurihara H, Mariani D, Martinez I, Pereira J, et al. ESTES guidelines: acute mesenteric ischaemia. Eur J Trauma Emerg Surg. 2016;42(2):253-70.
De Waele JJ, Kimball E, Malbrain M, Nesbitt I, Cohen J, Kaloiani V, et al. Decompressive laparotomy for abdominal compartment syndrome. Br J Surg. 2016;103(6):709-15.
Tallarita T, Oderich GS, Gloviczki P, Duncan AA, Kalra M, Cha S, et al. Patient survival after open and endovascular mesenteric revascularization for chronic mesenteric ischemia. J Vasc Surg. 2013;57(3):747-55; discussion 54-5.
Zierler RE, Jordan WD, Lal BK, Mussa F, Leers S, Fulton J, et al. The Society for Vascular Surgery practice guidelines on follow-up after vascular surgery arterial procedures. J Vasc Surg. 2018;68(1):256-84.
