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Prognostic Factors for Mesenteric Infarction: Multivariate Analysis of 187 Patients with Regard to Patient Age

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Annals of Vascular Surgery

Abstract

Between 1980 and 2002 a total of 187 patients (105 women, 82 men) with a mean age of 71.5 years underwent surgery for acute mesenteric infarction (AMI) in our department. Arterial occlusion was found in 140 patients, splanchnic vein thrombosis in 22, and nonocclusive AMI in 25. We performed bowel resection in 61 patients, vascular surgery in 32, a combination of the two in 15, and an exploratory laparotomy in 79. The mortality rate was 70.6% (73.9% in patients >70 years and 65.2% in those <70). AMI is still a disease with a consistently high mortality rate (60-80%). Multivariate prognostic factors include the time until surgery and a markedly elevated white blood cell count and serum lactate level. Mortality and secondary disease rates are higher in the elderly, and the fact that they have to wait much longer for an operation than younger patients may be a factor. If surgery is performed early, the survival rate increases regardless of age. The most important prognostic factor and the only one that can be influenced by the surgeon remains the time interval between the onset of symptoms and surgery, Therefore diagnostic and therapeutic intervention should be performed as early as possible in patients with suspected AMI.

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References

  1. JB Chang TA Stein (2003) ArticleTitleMesenteric ischemia: acute and chronic Ann Vasc Surg 17 323–328 Occurrence Handle10.1007/s10016-001-0249-7 Occurrence Handle12704549

    Article  PubMed  Google Scholar 

  2. TS Newman TH Magnuson SA Ahrendt MA Smith-Meek JS Bender (1998) ArticleTitleThe changing face of mesenteric infarction Am Surg 64 611–616 Occurrence Handle1:STN:280:DyaK1czhsl2ktw%3D%3D Occurrence Handle9655269

    CAS  PubMed  Google Scholar 

  3. MS Edwards GS Cherr TE Craven et al. (2003) ArticleTitleAcute occlusive mesenteric ischemia: surgical menagment and outcomes Ann Vasc Surg 17 72–79 Occurrence Handle10.1007/s10016-001-0329-8 Occurrence Handle12522695

    Article  PubMed  Google Scholar 

  4. PM Finucane T Arunachalam J O’Dowd MSJ Pathy (1989) ArticleTitleAcute mesenteric infarction in the elderly patient J Am Geriatr Soc 37 355–358 Occurrence Handle1:STN:280:BiaC2Mnhs1w%3D Occurrence Handle2921458

    CAS  PubMed  Google Scholar 

  5. JF Bronner P Boissel (1997) ArticleTitleAcute ischemia and arterial mesenteric infarction in patients aged over 75 years: apropos of a comparative series of 38 cases J Chir 134 109–113 Occurrence Handle1:STN:280:DyaK1c%2Fit1agtQ%3D%3D

    CAS  Google Scholar 

  6. B Sitges-Serra A Masx F Roquetta F Figueras (1988) ArticleTitleMesenteric infarction: an analysis of 83 patients with prognostic studies in 44 cases undergoing massive small bowel resection Br J Surg 75 544–548 Occurrence Handle1:STN:280:BieB1c7oslA%3D Occurrence Handle3395820

    CAS  PubMed  Google Scholar 

  7. R Stoney C Cunningham (1993) ArticleTitleAcute mesenteric ischemia Surgery 114 489–451 Occurrence Handle1:STN:280:ByyA2sjhslQ%3D Occurrence Handle8367801

    CAS  PubMed  Google Scholar 

  8. BM Sanders MC Dalsing (2003) ArticleTitleMesenteric ischemia affects young adults with predisposition Ann Vasc Surg 17 270–276 Occurrence Handle12712370

    PubMed  Google Scholar 

  9. JF Vollmar (1989) Rekonstruktive Chirurgie der Arterien., EditionNumber4th ed Thieme Verlag Stuttgart

    Google Scholar 

  10. W Sendt G Wolff-Vorbeck J Leipziger BU Specht U Schoffel (2000) ArticleTitleIn vitro peritonitis: basic inflammatory reactions in a two-chamber coculture model of human peritoneum Int J Colorectal Dis 15 229–235 Occurrence Handle1:STN:280:DC%2BD3cvlt1ensA%3D%3D Occurrence Handle11008723

    CAS  PubMed  Google Scholar 

  11. E Paes JF Vollmar S Hutschenreiter MH Schoenberg R Kübel E Schölzel (1988) ArticleTitleDer Mesenterialinfarkt: Neue Aspekte der Diagnotik und Therapie Chirurg 59 828–835 Occurrence Handle1:STN:280:BiaC28bptVE%3D Occurrence Handle3234093

    CAS  PubMed  Google Scholar 

  12. T Böttger W Schäfer T Junginger (1991) ArticleTitleEine prospektive Studie zur Evaluierung des postoperativen Risikos sowie der Langzeitprognose des Mesenterialinfarktes Med Klin 86 198–203 Occurrence Handle2056985

    PubMed  Google Scholar 

  13. RJAM Dongen ParticleVan ED Schwilden (1976) ArticleTitleDie chronischen intestinalen Durchlutungsstörungen Chirurg 47 366–379 Occurrence Handle954512

    PubMed  Google Scholar 

  14. C Glättli C Seiler A Metzger P Stirnemann U Baer (1994) ArticleTitleThe second-look laparoscopy after mesenteric infarction Langenbecks Arch Chir 379 66–69 Occurrence Handle8196430

    PubMed  Google Scholar 

  15. GM Graeber PJ Cafferty MJ Reardon (1981) ArticleTitleChanges of serum creatine phosphokinase and its isoenzymes caused by experimental ligature of the superior mesenteric artery Ann Surg 193 499–505 Occurrence Handle1:CAS:528:DyaL3MXhvV2rtrk%3D Occurrence Handle7212812

    CAS  PubMed  Google Scholar 

  16. LD May MM Berenson (1988) ArticleTitleValue of serum phosphate in the diagnosis of ischemic bowel disease Arch Surg 183 266–269

    Google Scholar 

  17. M Zeitz (2001) ArticleTitleShock-associated nonocclusive ischemic colitis: a very rare event in young patients after trauma Int J Colorectal Dis 16 58–59 Occurrence Handle1:STN:280:DC%2BD3MvntlCitA%3D%3D Occurrence Handle11317700

    CAS  PubMed  Google Scholar 

  18. M Murray M Gonze L Nowak (1994) ArticleTitleSerum D(−)-lactate levels as an aid to diagnosing acute intestinal ischemia Am J Surg 167 575–578 Occurrence Handle1:CAS:528:DyaK2cXltlWns74%3D Occurrence Handle8209931

    CAS  PubMed  Google Scholar 

  19. MJ Murray JJ Barbose CF Cobb (1993) ArticleTitleSerum D (−)-lactate levels as a predictor of acute intestine ischemia in a rat model J Surg Res 54 597–609 Occurrence Handle8412070

    PubMed  Google Scholar 

  20. R Inderbitzi H Hassler J Teuscher P Stirnemann (1990) ArticleTitleDie akute mesenteriale Ischämie Chirurg 61 530–534 Occurrence Handle1:STN:280:By%2BA28jmsFU%3D Occurrence Handle2394194

    CAS  PubMed  Google Scholar 

  21. W Flinn R Rizzo J Park G Sandager (1990) ArticleTitleDuplex scanning for assesment of mesenteric ischemia Surg Clin North Am 70 99–107 Occurrence Handle1:STN:280:By%2BC283jtFU%3D Occurrence Handle2406977

    CAS  PubMed  Google Scholar 

  22. GP Naude FS Bongard (1998) ArticleTitleRetrograde hepatic venous flow: a sign of mesenteric infarction Ann. Vasc. Surg 12 309–311 Occurrence Handle1:STN:280:DyaK1c3ksl2gtA%3D%3D Occurrence Handle9588522

    CAS  PubMed  Google Scholar 

  23. HC Umplepy (1987) ArticleTitleThrombosis of the superior mesenteric vein Br J Surg 74 694–696 Occurrence Handle3115353

    PubMed  Google Scholar 

  24. W Wiesner UV Willi (2001) ArticleTitleNonocclusive ischemic colitis: value of unenhanced spiral computed tomography Int J Colorectal Dis 16 55–57 Occurrence Handle1:STN:280:DC%2BD3MvntlCitw%3D%3D Occurrence Handle11317699

    CAS  PubMed  Google Scholar 

  25. Y Inoue U Schichijo K Ibukuro (1995) ArticleTitleIndikation der intraarteriellen Infusion von Urokinase in der Behandlung der akuten Darmischämie RoFo 143 660–664

    Google Scholar 

  26. P Klein M Bruckschlegel H Schweiger (1990) ArticleTitleThe value of revascularisation in arterial mesenteric infarction Langenbecks Arch Chir 375 220–224 Occurrence Handle1:STN:280:By%2BA28bps1E%3D Occurrence Handle2395389

    CAS  PubMed  Google Scholar 

  27. G Guillard B Pedelaborde G Eyoum J Loire JP Alamy (1996) ArticleTitleMesenteric infarction: resection and second-look surgery J Chir (Paris) 133 46–47 Occurrence Handle1:STN:280:BymA3MfotVQ%3D

    CAS  Google Scholar 

  28. DJ Deehan SD Heys J Brittenden (1995) ArticleTitleMesenteric ischemia: prognostic factors and influence of delay upon outcome J R Coll Surg Edinb 40 112–115 Occurrence Handle1:STN:280:ByqB1MvovFE%3D Occurrence Handle7776272

    CAS  PubMed  Google Scholar 

Download references

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Correspondence to Joerg-Peter Ritz MD.

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Ritz, JP., Germer, CT. & Buhr, H.J. Prognostic Factors for Mesenteric Infarction: Multivariate Analysis of 187 Patients with Regard to Patient Age. Ann Vasc Surg 19, 328–334 (2005). https://doi.org/10.1007/s10016-005-0005-5

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