Acute mesenteric ischaemia

Abstract

Acute mesenteric ischaemia (AMI) is a rare vascular emergency, but one that must be excluded as a cause of acute abdominal pain, especially in older patients, as it has a very high mortality rate. It is a time-critical disease process, and the best outcomes are seen when patients are rapidly diagnosed at the early stage and referred immediately to a hospital with vascular surgery, general surgery and interventional radiology services available. The aim of this article is to cover the diagnosis and management of AMI mainly from a primary care level. The aetio-pathology and clinical presentation of AMI will be described, and particular emphasis will be on how to identify AMI early, the importance of rapid referral, and appropriate approaches to risk factor reduction. There will be a brief discussion on the various secondary care management strategies. However, the main purpose of the article is to better equip GPs to optimally manage AMI in the community and thus improve global AMI outcomes.