Acute mesenteric ischemia (part I) - Incidence, etiologies, and how to improve early diagnosis
(2017) In 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.
(Less)
- author
- Kärkkäinen, Jussi M.
and Acosta, Stefan
LU
- organization
- publishing date
- 2017
- 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
- Best Practice and Research in Clinical Gastroenterology
- volume
- 31
- issue
- 1
- pages
- 15 - 25
- publisher
- Baillière Tindall
- external identifiers
-
- scopus:85009231882
- pmid:28395784
- 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
- 2025-02-17 09:39:34
@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}}, keywords = {{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 = {{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}}, doi = {{10.1016/j.bpg.2016.10.018}}, volume = {{31}}, year = {{2017}}, }