title: Acute mesenteric ischemia.
abstract: Acute mesenteric ischemia is a life-threatening condition that occurs when an abrupt decrease in blood flow results in inadequate supply to the intestines, leading to bowel infarction. Etiologies may include arterial embolus, arterial or venous thrombosis, and nonocclusive mesenteric ischemia. Other causes include vasculitis, traumatic injury, dissection of the aorta, cholesterol emboli, and intestinal obstruction. Mortality rates can approach 90% in the setting of bowel infarction. As such, it is important to establish an early diagnosis before the onset of bowel infarction. Treatment has traditionally involved surgical management. However, endovascular approaches have been increasingly reported in multiple case series describing success with initial endovascular therapy followed by open surgical intervention in some cases. Acuity of presentation, presence of bowel infarction, etiology of the ischemia, and risk factors may influence a planned treatment approach. The key to successful treatment of acute mesenteric ischemia involves early clinical recognition based on a detailed history and physical examination along with assessment of contributory risk factors, rapid acquisition of appropriate diagnostics to confirm a diagnosis, and early intervention to correct the underlying abnormality.
authors: Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA. Electronic address: Jrs7r@virginia.edu.
authors: James R
authors: JR
authors: Stone
authors: Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA.
authors: Luke R
authors: LR
authors: Wilkins
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D065666:Mesenteric Ischemia / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011237:Predictive Value of Tests; D015641:Radiography, Interventional; D012307:Risk Factors; D013152:Splanchnic Circulation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: endovascular; interventional radiology; mesenteric ischemia; thrombectomy; thrombolysis