TY - JOUR
T1 - Acute mesenteric ischemia
AU - Stone, James R.
AU - Wilkins, Luke R.
N1 - Publisher Copyright:
© 2015 Elsevier Inc..
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Acute mesenteric ischemia is a life-threatening condition that occurs when an abrupt decrease in blood flow results in inadequate supply to the intestines, leading to bowel infarction. Etiologies may include arterial embolus, arterial or venous thrombosis, and nonocclusive mesenteric ischemia. Other causes include vasculitis, traumatic injury, dissection of the aorta, cholesterol emboli, and intestinal obstruction. Mortality rates can approach 90% in the setting of bowel infarction. As such, it is important to establish an early diagnosis before the onset of bowel infarction. Treatment has traditionally involved surgical management. However, endovascular approaches have been increasingly reported in multiple case series describing success with initial endovascular therapy followed by open surgical intervention in some cases. Acuity of presentation, presence of bowel infarction, etiology of the ischemia, and risk factors may influence a planned treatment approach. The key to successful treatment of acute mesenteric ischemia involves early clinical recognition based on a detailed history and physical examination along with assessment of contributory risk factors, rapid acquisition of appropriate diagnostics to confirm a diagnosis, and early intervention to correct the underlying abnormality.
AB - Acute mesenteric ischemia is a life-threatening condition that occurs when an abrupt decrease in blood flow results in inadequate supply to the intestines, leading to bowel infarction. Etiologies may include arterial embolus, arterial or venous thrombosis, and nonocclusive mesenteric ischemia. Other causes include vasculitis, traumatic injury, dissection of the aorta, cholesterol emboli, and intestinal obstruction. Mortality rates can approach 90% in the setting of bowel infarction. As such, it is important to establish an early diagnosis before the onset of bowel infarction. Treatment has traditionally involved surgical management. However, endovascular approaches have been increasingly reported in multiple case series describing success with initial endovascular therapy followed by open surgical intervention in some cases. Acuity of presentation, presence of bowel infarction, etiology of the ischemia, and risk factors may influence a planned treatment approach. The key to successful treatment of acute mesenteric ischemia involves early clinical recognition based on a detailed history and physical examination along with assessment of contributory risk factors, rapid acquisition of appropriate diagnostics to confirm a diagnosis, and early intervention to correct the underlying abnormality.
KW - Endovascular
KW - Interventional radiology
KW - Mesenteric ischemia
KW - Thrombectomy
KW - Thrombolysis
UR - http://www.scopus.com/inward/record.url?scp=84925337618&partnerID=8YFLogxK
U2 - 10.1053/j.tvir.2014.12.004
DO - 10.1053/j.tvir.2014.12.004
M3 - Article
C2 - 25814200
AN - SCOPUS:84925337618
SN - 1089-2516
VL - 18
SP - 24
EP - 30
JO - Techniques in Vascular and Interventional Radiology
JF - Techniques in Vascular and Interventional Radiology
IS - 1
ER -