Abstract
Results Acute ischemia of the bowel mesentery was diagnosed in 41 patients (27 women and 14 men; mean age, 65.4 years). All patients underwent laparotomy. For 13 (31.71%) patients, surgery was performed within the first 24 hours of the clinical symptom onset. Mesenteric artery embolectomy without intestine resection was performed for 7 (17.07%) patients. Partial intestine resection due to necrosis was performed for 21 (51.22%) patients. Exploratory laparotomy without a therapeutic procedure was performed for 13 (31.71%) patients. Fifteen (36.59%) patients were discharged home in good general condition. Twenty-six (63.41%) patients died. The time from the clinical symptom onset until intervention exceeded 24 hours for all patients who died. Surgery within the first 24 hours reduced mortality associated with acute mesenteric ischemia (P = 0.001). Female sex, age older than 65 years, obesity (body mass index > 30), diabetes, chronic kidney disease, and smoking were adverse prognostic factors for increased mortality for patients with acute bowel ischemia. Conclusion The time from clinical symptoms to acute mesenteric ischemia treatment was the main prognostic factor and helped determine appropriate management. Early diagnosis and rapid intervention improved treatment outcomes and survival.
Highlights
Acute mesenteric ischemia, rare, is associated with numerous complications and death
We performed a retrospective analysis of all patients diagnosed with acute mesenteric ischemia of occlusive cause who were hospitalized between January 1, 2002, and December 31, 2018, at our institution
Forty-one patients (27 women and 14 men; mean age, 65.4 years) with acute mesenteric ischemia were hospitalized between January 1, 2002, and December 31, 2018
Summary
Rare, is associated with numerous complications and death. This work presents acute mesenteric ischemia treatment based on an analysis of various management strategies and identifies prognostic factors that influence therapy effectiveness. For 13 (31.71%) patients, surgery was performed within the first 24 hours of the clinical symptom onset. Mesenteric artery embolectomy without intestine resection was performed for 7 (17.07%) patients. Partial intestine resection due to necrosis was performed for 21 (51.22%) patients. Exploratory laparotomy without a therapeutic procedure was performed for 13 (31.71%) patients. The time from the clinical symptom onset until intervention exceeded 24 hours for all patients who died. The time from clinical symptoms to acute mesenteric ischemia treatment was the main prognostic factor and helped determine appropriate management. Diverse causes and nonspecific clinical symptoms of patients with acute mesenteric ischemia hinder the diagnostic process, often resulting in delayed diagnosis and late therapeutic intervention. Further studies of acute bowel ischemia focused on creating uniform diagnostic and therapeutic standards are necessary [1,2,3,4,5,6,7,8,9,10]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
