title: Mesenteric ischemia--outcome after surgical therapy in 83 patients.
abstract: BACKGROUND
  Intestinal ischemia is the prime vascular emergency for the visceral surgeon. However, the diagnosis of mesenteric ischemia is difficult, the surgical options are often limited and the overall outcome is generally poor.
  
  
  METHODS
  We report on a single center series of 83 patients undergoing surgery for mesenteric ischemia during a 3-year period. Risk factors, clinical presentation, type and timing of imaging studies and their implications for surgical therapy and outcome are analyzed.
  
  
  RESULTS
  Hypertension and diabetes were the most common risk factors (68/64% of all patients). Abdominal pain was the most general symptom upon presentation to the surgical unit (73%). Two-phase, contrast-enhanced computed tomography was applied as the standard preoperative imaging modality (correct diagnosis in 69%). Bowel resections were necessary in most patients; approaches to restore blood flow by vascular surgery interventions were applied in 17 patients (20%). The overall morbidity and mortality rate in our study cohort was expectedly high (59% 1 month mortality).
  
  
  CONCLUSIONS
  The diagnosis and surgical treatment of mesenteric ischemia remains a major difficulty. We recommend preoperative CT analysis followed by an aggressive indication for early surgical exploration and bowel resection. An attempt of revascularization is justified for selected patients with limited macrovascular disease.
authors.affiliation: Department of Surgery, University of Regensburg, Regensburg, Germany. marc.dahlke@klinik.uni-regensburg.de
authors.forename: M H
authors.initials: MH
authors.lastname: Dahlke
authors.forename: L
authors.initials: L
authors.lastname: Asshoff
authors.forename: F C
authors.initials: FC
authors.lastname: Popp
authors.forename: S
authors.initials: S
authors.lastname: Feuerbach
authors.forename: S A
authors.initials: SA
authors.lastname: Lang
authors.forename: P
authors.initials: P
authors.lastname: Renner
authors.forename: P
authors.initials: P
authors.lastname: Slowik
authors.forename: O
authors.initials: O
authors.lastname: Stoeltzing
authors.forename: H J
authors.initials: HJ
authors.lastname: Schlitt
authors.forename: P
authors.initials: P
authors.lastname: Piso
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D008297:Male; D008643:Mesentery / Q000098:blood supply*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome