Skip to main content
SpringerLink
Log in

Mesenteric Ischemia

  • Chapter
  • First Online:
Book cover Emergency General Surgery

  • 1689 Accesses

Abstract

Acute mesenteric ischemia is a life-threatening surgical emergency. Despite improvements in imaging technology and surgical technique, mortality remains high. The diagnosis must be made in an expeditious fashion, as time is bowel. Chronic mesenteric ischemia, although not an imminent threat to life, can be associated with significant malnutrition and is a marker for more widespread atherosclerotic disease. The management of chronic mesenteric ischemia has evolved from open surgical bypass to minimally invasive revascularization as technology continues to improve. The acute care surgeon must develop a high clinical suspicion for these rare but important disease processes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Amitrano L, Guardascione MA, Scaglione M, Pezzullo L, Sangiuliano N, Armellino MF, Manguso F, Margaglione M, Ames PR, Iannaccone L. Prognostic factors in noncirrhotic patients with splanchnic vein thromboses. Am J Gastroenterol. 2007;102:2464.

    Article  Google Scholar 

  2. Brunaud L, Antunes L, Collinet-Adler S, Marchal F, Ayav A, Bresler L, Boissel P. Acute mesenteric venous thrombosis: case for nonoperative management. J Vasc Surg. 2001;34:673–9.

    Article  CAS  Google Scholar 

  3. Chandra A, Quinones-Baldrich WJ. Chronic mesenteric ischemia: how to select patients for invasive treatment. Semin Vasc Surg. 2010;23:21–8.

    Article  Google Scholar 

  4. Cokkinis A. Mesenteric vascular occlusion. South Med J. 1926;19:655.

    Article  Google Scholar 

  5. Dentali F, Ageno W, Witt D, Malato A, Clark N, Garcia D, Mccool K, Siragusa S, Dyke S, Crowther M. Natural history of mesenteric venous thrombosis in patients treated with vitamin K antagonists: a multi-centre, retrospective cohort study. Thromb Haemost. 2009;102:501–4.

    Article  CAS  Google Scholar 

  6. From AM, Bartholmai BJ, Williams AW, Cha SS, Mcdonald FS. Mortality associated with nephropathy after radiographic contrast exposure. Mayo Clin Proc. 2008;83:1095–100.

    Article  Google Scholar 

  7. Hollingshead M, Burke CT, Mauro MA, Weeks SM, Dixon RG, Jaques PF. Transcatheter thrombolytic therapy for acute mesenteric and portal vein thrombosis. J Vasc Interv Radiol. 2005;16:651–61.

    Article  Google Scholar 

  8. Kearon C, Akl EA, Comerota AJ, Prandoni P, Bounameaux H, Goldhaber SZ, Nelson ME, Wells PS, Gould MK, Dentali F, Crowther M, Kahn SR. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:e419S–96S.

    Article  CAS  Google Scholar 

  9. Kumar S, Sarr MG, Kamath PS. Mesenteric venous thrombosis. N Engl J Med. 2001;345:1683–8.

    Article  CAS  Google Scholar 

  10. Lock G. Acute intestinal ischaemia. Best Pract Res Clin Gastroenterol. 2001;15:83–98.

    Article  CAS  Google Scholar 

  11. Menke J. Diagnostic accuracy of multidetector CT in acute mesenteric ischemia: systematic review and meta-analysis. Radiology. 2010;256:93–101.

    Article  Google Scholar 

  12. Mitchell EL, Moneta GL. Mesenteric duplex scanning. Perspect Vasc Surg Endovasc Ther. 2006;18:175–83.

    Article  Google Scholar 

  13. Mitsuyoshi A, Obama K, Shinkura N, Ito T, Zaima M. Survival in nonocclusive mesenteric ischemia: early diagnosis by multidetector row computed tomography and early treatment with continuous intravenous high-dose prostaglandin E(1). Ann Surg. 2007;246:229–35.

    Article  Google Scholar 

  14. Oldenburg WA, Lau LL, Rodenberg TJ, Edmonds HJ, Burger CD. Acute mesenteric ischemia: a clinical review. Arch Intern Med. 2004;164:1054–62.

    Article  Google Scholar 

  15. Park WM, Cherry KJ, Chua HK, Clark RC, Jenkins G, Harmsen WS, Noel AA, Panneton JM, Bower TC, Hallett JW, Gloviczki P. Current results of open revascularization for chronic mesenteric ischemia: a standard for comparison. J Vasc Surg. 2002;35:853–9.

    Article  Google Scholar 

  16. Roobottom C, Dubbins P. Significant disease of the celiac and superior mesenteric arteries in asymptomatic patients: predictive value of Doppler sonography. AJR Am J Roentgenol. 1993;161:985–8.

    Article  CAS  Google Scholar 

  17. Schoots I, Koffeman G, Legemate D, Levi M, Van Gulik T. Systematic review of survival after acute mesenteric ischaemia according to disease aetiology. Br J Surg. 2004;91:17–27.

    Article  CAS  Google Scholar 

  18. Schoots IG, Levi MM, Reekers JA, Lameris JS, Van Gulik TM. Thrombolytic therapy for acute superior mesenteric artery occlusion. J Vasc Interv Radiol. 2005;16:317–29.

    Article  Google Scholar 

  19. Siegelman SS, Sprayregen S, Boley SJ. Angiographic diagnosis of mesenteric arterial vasoconstriction. Radiology. 1974;112:533–42.

    Article  CAS  Google Scholar 

  20. Smerud MJ, Johnson CD, Stephens DH. Diagnosis of bowel infarction: a comparison of plain films and CT scans in 23 cases. Am J Roentgenol. 1990;154:99–103.

    Article  CAS  Google Scholar 

  21. Walker TG. Mesenteric ischemia. Seminars in interventional radiology: © Thieme Medical Publishers; USA. 2009. p. 175–83.

    Article  Google Scholar 

  22. Wyers MC, Powell RJ, Nolan BW, Cronenwett JL. Retrograde mesenteric stenting during laparotomy for acute occlusive mesenteric ischemia. J Vasc Surg. 2007;45:269–75.

    Article  Google Scholar 

  23. Yang S, Fan X, Ding W, Liu B, Meng J, Wang K, Wu X, LI J. D-dimer as an early marker of severity in patients with acute superior mesenteric venous thrombosis. Medicine. 2014;93:e270.

    Article  CAS  Google Scholar 

  24. Zettervall SL, Lo RC, Soden PA, Deery SE, Ultee KH, Pinto DS, Wyers MC, Schermerhorn ML. Trends in treatment and mortality for mesenteric ischemia in the United States from 2000 to 2012. Ann Vasc Surg. 2017;42:111–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. USAF, MC, David Grant USAF Medical Center; University of California Davis Medical Center, Division of Vascular and Endovascular Surgery, Sacramento, CA, USA

    Meryl A. Simon

  2. Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA

    Joseph J. DuBose

Authors
  1. Meryl A. Simon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joseph J. DuBose
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Dell Medical School, University of Texas at Austin, Austin, TX, USA

    Carlos V. R. Brown

  2. Trauma and Surgical Critical Care, University of Southern California, Los Angeles, CA, USA

    Kenji Inaba

  3. Madigan Army Medical Center, Tacoma, WA, USA

    Matthew J. Martin

  4. Brigham and Womens’s Hospital, Harvard Medical School, Boston, MA, USA

    Ali Salim

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Simon, M.A., DuBose, J.J. (2019). Mesenteric Ischemia. In: Brown, C., Inaba, K., Martin, M., Salim, A. (eds) Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-96286-3_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-96286-3_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-96285-6

  • Online ISBN: 978-3-319-96286-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation