ACUTE MESENTERIC ISCHEMIA WITH BOWEL GANGRENE:CASE SERIES IN A TERTIARY CARE CENTRE

Abstract

Introduction: Acute Mesenteric ischemia (AMI) is a worrisome clinical condition leading to end stage irreversible bowel necrosis. Inspite of advances in medical eld, it continues to remain a diagnostic challenge for surgeons leading to delay in diagnosis and high mortality. In this series we present 8 cases of AMI with bowel gangrene treated surgically with an aim to describe its presentation and various management strategies at our institution. This prospective series of patients operated for acute mesenteri Methodology: c ischemia with bowel gangrene was conducted in a tertiary care hospital in Eastern India from January 2021 to August 2022. All patients presenting to the emergency department with abdominal pain, features of obstruction with or without peritonitis operated with a pre operative diagnosis of acute mesenteric ischemia conrmed radiologically were taken for the study. This series comprised of 8 patients, of which 5 (62.5%) were Results: male and 3 (37.5%) were female. The mean age of patients was 58.5 ± 8.9 years with a range from 45 to 75 years. The most consistent presenting feature was abdominal pain (100%) followed by vomiting (50%) and distension (50%). Four (50%) of patients had a pre-existing cardiac illness. The mean length of hospital stay was 7.6 ± 3.87 days. Post operative complication occurred in 4 patients. The mortality rate in our series was 37.5%. AMI is a life threatening vascular Conclusion: emergency with high mortality and morbidity. Most present in a delayed stage where irreversible bowel ischemia has set in requiring emergency laparotomy. High index of clinical suspicion is required for early diagnosis and prompt effective treatment to prevent disastrous consequences.