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Acute Mesenteric Ischemia Involving the Colon

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Abstract

Acute mesenteric ischemia is a surgical emergency with dismal prognosis. Its management consists of prompt diagnosis with expedite surgery. The ischemic bowel segments need to be resected, and a vascular intervention, thrombectomy mostly, is required in appropriate cases. The colon involvement as part of the ischemic process was rarely examined in detail. The purpose of this study was to describe the management, outcomes, and risk factors of patients with acute mesenteric ischemia involving the colon. Case series analysis of computerized historical patient records, who presented with acute mesenteric ischemia between 2010 and 2021 in a single tertiary care center, was performed. Sixty patients met the inclusion criteria and underwent surgery for acute mesenteric ischemia. Peritonitis was present in 16/60 which significantly increased mortality(p = 0.043). Twenty-one patients had intraoperative findings of colon ischemia with 14 who underwent colon resection as part of their surgery. These patients had a high mortality of 71.4%, and colon involvement was found to be a prognostic factor with p = 0.028. Patients with atrial fibrillation had a higher incidence of large bowel ischemia on computed tomography (p = 0.029). Advanced age of over 76 was also found as a risk factor for mortality. Colon involvement as part of acute mesenteric ischemia carries a dismal prognosis with high index of suspicion and prompt surgical treatment required.

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Data Availability

The data that support the findings of the study are availabe in a controlled access data storage at Rambam Health Care Campus.

References

  1. Altinyollar H, Boyabatli M, Berberoğlu U (2006) D-dimer as a marker for early diagnosis of acute mesenteric ischemia. Thromb Res 117(4):463–7

    Article  CAS  PubMed  Google Scholar 

  2. Dundar ZD, Cander B, Gul M et al (2010) Serum ischemia-modified albumin levels in an experimental acute mesenteric ischemia model. Acad Emerg Med 17(11):1233–8

    Article  PubMed  Google Scholar 

  3. Gunduz A, Turkmen S, Turedi S et al (2009) Time-dependent variations in ischemia-modified albumin levels in mesenteric ischemia. Acad Emerg Med 16(6):539–543

    Article  PubMed  Google Scholar 

  4. Bala M, Catena F, Kashuk J et al (2022) Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. World J Emerg Surg 17(1):54

    Article  PubMed  PubMed Central  Google Scholar 

  5. Garzelli L, Nuzzo A, Copin P et al (2020) Contrast-enhanced CT for the diagnosis of acute mesenteric ischemia. AJR Am J Roentgenol 215(1):29–38

    Article  PubMed  Google Scholar 

  6. Ksouri A, Copin P, Bonvalet F et al (2022) Colonic involvement in acute mesenteric ischemia: prevalence, risk factors, and outcomes. Eur Radiol 32(4):2813–2823

    Article  PubMed  Google Scholar 

  7. Longstreth GF, Yao JF (2009) Epidemiology, clinical features, high-risk factors, and outcome of acute large bowel ischemia. Clin Gastroenterol Hepatol 7(10):1075–1080

    Article  PubMed  Google Scholar 

  8. Elder K, Lashner BA, Al SF (2009) Clinical approach to colonic ischemia. Cleve Clin J Med 76(7):401–409

    Article  PubMed  Google Scholar 

  9. Park CJ, Jang MK, Shin WG et al (2007) Can we predict the development of ischemic colitis among patients with lower abdominal pain? Dis Colon Rectum 50:232–238

    Article  PubMed  Google Scholar 

  10. Feuerstadt P, Brandt LJ (2015) Update on colon ischemia: recent insights and advances. Curr Gastroenterol Rep 17(12):45

    Article  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of General Surgery, Rambam Health Care Campus, Haifa, Israel

    Rozan Marjiyeh, Mariya Neymark, Roi Abramov & Hayim Gilshtein

  2. Department of Radiology, Rambam Health Care Campus, Haifa, Israel

    Ahmed Mahagneh

  3. Colorectal Unit, Rambam Health Care Campus, Haifa, Israel

    Hayim Gilshtein

Authors
  1. Rozan Marjiyeh
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  2. Mariya Neymark
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  3. Roi Abramov
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  4. Ahmed Mahagneh
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  5. Hayim Gilshtein
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Corresponding author

Correspondence to Hayim Gilshtein.

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The research is not involving human participants and/or animals. Informed consent in not applicable for this retrospective cohort data collection.

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The authors declare no competing interests.

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Marjiyeh, R., Neymark, M., Abramov, R. et al. Acute Mesenteric Ischemia Involving the Colon. Indian J Surg (2023). https://doi.org/10.1007/s12262-023-03883-0

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  • DOI: https://doi.org/10.1007/s12262-023-03883-0

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