Acute Mesenteric Ischemia: Basic concepts, Diagnosis, Treatment Options and Outcomes.

Abstract

Acute mesenteric ischemia (AMI) is a group of diseases in which blood flow to the intestine is interrupted by occlusive or nonocclusive causes that include mesenteric arterial embolism, mesenteric arterial thrombosis, and mesenteric venous thrombosis. AMI risk factors include advanced age, Caucasian race, history of systemic arterial hypertension, arterial fibrillation, chronic kidney disease, and congestive heart failure. The clinical triad is characterized by the sudden onset of severe abdominal pain accompanied by gastrointestinal symptoms in the presence of an identified embolic source. Diagnosis is commonly made using computed tomography angiography, where the obstruction is observed directly in occlusive causes. Treatment involves fluid resuscitation and restoring mesenteric artery circulation using endovascular or surgical procedures. The mortality rate varies depending on the patient's clinical history and treatment approach, with a higher risk associated with open surgery. Lifelong anticoagulation or antiplatelet therapy may be necessary to prevent recurrence. Follow-up evaluations are recommended to monitor for restenosis and to prevent acute myocardial infarction.