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Acute Mesenteric Ischemia

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Textbook of Emergency General Surgery

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Abstract

The acute mesenteric ischemia (AMI) is a life-threatening emergency. Prognosis of superior mesenteric artery (SMA) obstruction is poor (99% risk of mortality in the absence of treatment). With increasing awareness among physicians, primarily in the fields of surgery, emergency medicine as well as gastroenterology a reduction in AMI-associated mortality from 90% to 50% could be achieved in the last 30 years.

The clinical picture is dominated by abdominal pain, usually without any other associated specific sign. Onset of intestinal necrosis along with related morbidity and mortality is directly linked to the delay in management: early diagnosis and treatment of arterial AMI are key to improve outcome. There are no specific laboratory tests, and it is essential to obtain arterial and portal phases of contrast-enhanced computerized tomography angiography (CTA).

The prompt and targeted use of the appropriate interventions appears to be the only way to reduce the persistently high mortality rates for AMI. Surgical treatment is a mainstay and sounds like an orchestra of the general surgery, vascular and intensive care teams.

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Authors and Affiliations

  1. Trauma and Acute Care Surgery Unit, Hadassah—Hebrew University Medical Center, Jerusalem, Israel

    Miklosh Bala & Asaf Kedar

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  1. Miklosh Bala
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  2. Asaf Kedar
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Correspondence to Miklosh Bala .

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Editors and Affiliations

  1. General, Emergency and Trauma Surgery Dept., Pisa University Hospital, Pisa, Italy

    Federico Coccolini

  2. General and Emergency Surgery Dept., Bufalini Hospital, Cesena, Italy

    Fausto Catena

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Bala, M., Kedar, A. (2023). Acute Mesenteric Ischemia. In: Coccolini, F., Catena, F. (eds) Textbook of Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-22599-4_68

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  • DOI: https://doi.org/10.1007/978-3-031-22599-4_68

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