[Current diagnosis and therapy of non-occlusive mesenteric ischemia].
OBJECTIVE
Non-occlusive mesenteric ischemia (NOMI) is a life threatening disease. Therapy and prognosis depend upon the length of time elapsed between primary clinical manifestation and the time of definitive diagnosis and treatment.


METHODS
NOMI was diagnosed by intraarterial selective angiography in four patients. After a bolus administration of 20 g Alprostadil (Prostavasin) into the superior mesenteric artery, intraarterial perfusion was continued with 60 microg Alprostadil/day via the catheter for three days.


RESULTS
The mesenteric ischemia resolved in all patients. One patient recovered completely. Three patients recovered from mesenteric ischemia, but died subsequently due to complications of their primary diseases.


CONCLUSIONS
When NOMI without perforation or necrosis of the bowel wall is suspected clinically, immediate intraarterial angiography is the diagnostic method of choice. If NOMI is confirmed, the appropriate treatment is the intraarterial application of potent vasodilators for several days. The diagnostic work-up in suspected NOMI and the impact of different radiological examinations are explained. The literature is reviewed.
Ernst
S
S
Institut für Diagnostische Radiologie, Heinrich-Heine-Universität, Dusseldorf. stefan.ernst@mkh-bgl.de
Luther
B
B
Zimmermann
N
N
Böhner
H
H
Wilke
R
R
Feindt
P
P
Fürst
G
G
D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage; D000792:Angiography; D002318:Cardiovascular Diseases / Q000601:surgery; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D007511:Ischemia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging / Q000187:drug effects; D008643:Mesentery / Q000098:blood supply*; D008875:Middle Aged; D010348:Patient Care Team; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D014665:Vasodilator Agents / Q000008:administration & dosage
D014665:Vasodilator Agents; D000527:Alprostadil