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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The data that support the findings of the study are availabe in a controlled access data storage at Rambam Health Care Campus.
References
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
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
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
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
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
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
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
Elder K, Lashner BA, Al SF (2009) Clinical approach to colonic ischemia. Cleve Clin J Med 76(7):401–409
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
Feuerstadt P, Brandt LJ (2015) Update on colon ischemia: recent insights and advances. Curr Gastroenterol Rep 17(12):45
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Marjiyeh, R., Neymark, M., Abramov, R. et al. Acute Mesenteric Ischemia Involving the Colon. Indian J Surg 86, 348–354 (2024). https://doi.org/10.1007/s12262-023-03883-0
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DOI: https://doi.org/10.1007/s12262-023-03883-0