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Acute mesenteric ischemia (part I) - Incidence, etiologies, and how to improve early diagnosis

Kärkkäinen, Jussi M. and Acosta, Stefan LU (2017) In Bailliere's Best Practice and Research in Clinical Gastroenterology 31(1). p.15-25
Abstract

Acute mesenteric ischemia (AMI) is generally thought to be a rare disease, but in fact, it is more common cause of acute abdomen than appendicitis or ruptured abdominal aortic aneurysm in patients over 75 years of age. In occlusive AMI, surgical treatment without revascularization is associated with as high as 80% overall mortality. It has been shown that early diagnosis with contrast-enhanced computed tomography and revascularization can reduce the overall mortality in AMI by up to 50%. However, only a minority of patients with AMI are being treated actively with revascularization in the United States, and the situation is very likely similar in Europe as well. What can we do to improve diagnostic performance, so that more patients get... (More)

Acute mesenteric ischemia (AMI) is generally thought to be a rare disease, but in fact, it is more common cause of acute abdomen than appendicitis or ruptured abdominal aortic aneurysm in patients over 75 years of age. In occlusive AMI, surgical treatment without revascularization is associated with as high as 80% overall mortality. It has been shown that early diagnosis with contrast-enhanced computed tomography and revascularization can reduce the overall mortality in AMI by up to 50%. However, only a minority of patients with AMI are being treated actively with revascularization in the United States, and the situation is very likely similar in Europe as well. What can we do to improve diagnostic performance, so that more patients get proper treatment? The diagnosis is a collaborative effort of emergency department surgeons, gastrointestinal and vascular surgeons, and radiologists. The etiological categorization of AMI should be practical and guide the therapy. Furthermore, the limitations of the diagnostic examinations need to be understood with special emphasis on computed tomography findings on patients with slowly progressing "acute-on-chronic" mesenteric ischemia.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute mesenteric ischemia, Acute on chronic mesenteric ischemia, Computed tomography, Diagnosis, Etiology, Incidence, Mesenteric venous thrombosis, Nonocclusive mesenteric ischemia
in
Bailliere's Best Practice and Research in Clinical Gastroenterology
volume
31
issue
1
pages
15 - 25
publisher
Baillière Tindall
external identifiers
  • scopus:85009231882
  • wos:000400719800003
ISSN
1521-6918
DOI
10.1016/j.bpg.2016.10.018
language
English
LU publication?
yes
id
2b8d8689-6aa3-4582-ba55-2c3cf798dd43
date added to LUP
2017-02-10 13:42:31
date last changed
2018-03-11 04:37:17
@article{2b8d8689-6aa3-4582-ba55-2c3cf798dd43,
  abstract     = {<p>Acute mesenteric ischemia (AMI) is generally thought to be a rare disease, but in fact, it is more common cause of acute abdomen than appendicitis or ruptured abdominal aortic aneurysm in patients over 75 years of age. In occlusive AMI, surgical treatment without revascularization is associated with as high as 80% overall mortality. It has been shown that early diagnosis with contrast-enhanced computed tomography and revascularization can reduce the overall mortality in AMI by up to 50%. However, only a minority of patients with AMI are being treated actively with revascularization in the United States, and the situation is very likely similar in Europe as well. What can we do to improve diagnostic performance, so that more patients get proper treatment? The diagnosis is a collaborative effort of emergency department surgeons, gastrointestinal and vascular surgeons, and radiologists. The etiological categorization of AMI should be practical and guide the therapy. Furthermore, the limitations of the diagnostic examinations need to be understood with special emphasis on computed tomography findings on patients with slowly progressing "acute-on-chronic" mesenteric ischemia.</p>},
  author       = {Kärkkäinen, Jussi M. and Acosta, Stefan},
  issn         = {1521-6918},
  keyword      = {Acute mesenteric ischemia,Acute on chronic mesenteric ischemia,Computed tomography,Diagnosis,Etiology,Incidence,Mesenteric venous thrombosis,Nonocclusive mesenteric ischemia},
  language     = {eng},
  number       = {1},
  pages        = {15--25},
  publisher    = {Baillière Tindall},
  series       = {Bailliere's Best Practice and Research in Clinical Gastroenterology},
  title        = {Acute mesenteric ischemia (part I) - Incidence, etiologies, and how to improve early diagnosis},
  url          = {http://dx.doi.org/10.1016/j.bpg.2016.10.018},
  volume       = {31},
  year         = {2017},
}