J Korean Soc Vasc Surg.  2004 May;20(1):78-82.

Clinical Review of Acute Mesenteric Ischemia

• Jeong JD
• Lee JH
• Lee SJ
• Ryu SY
• Hwang SY

Abstract

PURPOSE
The purpose of this study was to review our clinical experiences of acute mesenteric ischemic disease at the Masan Samsung hospital. METHOD: Retrospectively reviewed the medical records of 20 patients with acute mesenteric ischemic disease from 1998 through 2003 in terms of clinical characteristics, image findings, management and results. RESULT: The mean age of patients was 63.5 years and the male female ratio was 1.5:1. Coexisting diseases were atrial fibrillation (n=10), hypertension (n=9), myocardial infarction (n=2), DM (n=4). The clinical manifestations were abdominal pain, abdominal distension, peritoneal irritation signs, vomiting and melena. The presenting signs were nonspecific. Laboratory findings were nonspecific and not helpful for diagnosis of acute mesenteric ischemia. Abdominal CT and SMA angiography were accurate and sensitive diagnostic tools. Seventeen cases were SMA occlusion (1 case: SMA dissection) and 3 cases were SMV occlusion. Operative procedures were resection of bowel (12 cases) and thromboembolectomy (5 cases). Non operative procedure was anticoagulation (3 cases). One patient refused surgery.
CONCLUSION
Both clinical and laboratory data were non-specific and delayed diagnosis was the main cause of the overall mortality rate of 35% (7 cases). The mortality rate for patients undergoing surgery for acute mesenteric ischemic disease was high, but early diagnosis and intensive care may be reduced mortality.

Keyword

Mesenteric vascular occlusion; Embolism; Thrombosis

MeSH Terms

Abdominal Pain
Angiography
Atrial Fibrillation
Critical Care
Delayed Diagnosis
Diagnosis
Early Diagnosis
Embolism
Female
Humans
Hypertension
Ischemia*
Male
Medical Records
Melena
Mesenteric Vascular Occlusion
Mortality
Myocardial Infarction
Retrospective Studies
Surgical Procedures, Operative
Thrombosis
Tomography, X-Ray Computed
Vomiting