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ACR appropriateness criteria® imaging of mesenteric ischemia

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An Erratum to this article was published on 17 June 2014

Abstract

Mesenteric ischemia is a rare disease associated with high morbidity and mortality. Acute mesenteric ischemia is most commonly secondary to embolism followed by arterial thrombosis, nonocclusive ischemia, and less commonly venous thrombosis. Chronic mesenteric ischemia is almost always caused by atherosclerotic disease, with rare causes including fibromuscular dysplasia and vasculitis. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Patients with mesenteric ischemia usually present with nonspecific abdominal symptoms and laboratory findings. This document evaluates and rates the appropriateness of imaging to evaluate patients with clinically suspected mesenteric ischemia. While catheter-based angiography has been considered the reference standard and enables diagnosis and treatment, advances in computed tomography have made it a first-line test in many patients because it is a fast, widely available, and noninvasive study. Abdominal radiographs and ultrasound have a limited role in diagnosing mesenteric ischemia but are commonly the first ordered tests in patients with abdominal pain and may diagnose more common pathologies.

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Disclaimer

The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. This article is a revised version of the American College of Radiology Appropriateness Criteria Imaging of Mesenteric Ischemia. Practitioners are encouraged to refer to the complete version at www.acr.org/ac.

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Authors and Affiliations

  1. Yale University School of Medicine, New Haven, CT, USA

    Isabel B. Oliva & Amir H. Davarpanah

  2. Brigham and Women’s Hospital, Boston, MA, USA

    Frank J. Rybicki, Marie D. Gerhard-Herman & Matthew P. Schenker

  3. University of Pennsylvania, Philadelphia, PA, USA

    Benoit Desjardins & Emile R. Mohler III

  4. Cleveland Clinic, Cleveland, OH, USA

    Scott D. Flamm

  5. University of Wisconsin, Madison, WI, USA

    Christopher J. Francois

  6. American College of Cardiology, Washington, DC, USA

    Emile R. Mohler III

  7. Massachusetts General Hospital, Boston, MA, USA

    Sanjeeva P. Kalva

  8. Vascular Associates, Grand Rapids, MI, USA

    M. Ashraf Mansour

  9. Society of Vascular Surgeons, Chicago, IL, USA

    M. Ashraf Mansour

  10. Johns Hopkins Bayview Medical Center, Baltimore, MD, USA

    Clifford Weiss

  11. University of Chicago, Chicago, IL, USA

    Karin E. Dill

Authors
  1. Isabel B. Oliva
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  2. Amir H. Davarpanah
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  3. Frank J. Rybicki
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  4. Benoit Desjardins
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  5. Scott D. Flamm
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  6. Christopher J. Francois
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  7. Marie D. Gerhard-Herman
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  8. Sanjeeva P. Kalva
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  9. M. Ashraf Mansour
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  10. Emile R. Mohler III
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  11. Matthew P. Schenker
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  12. Clifford Weiss
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  13. Karin E. Dill
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Corresponding author

Correspondence to Isabel B. Oliva.

Additional information

The authors listed above are the part of “Expert Panel on Vascular Imaging.”

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Oliva, I.B., Davarpanah, A.H., Rybicki, F.J. et al. ACR appropriateness criteria® imaging of mesenteric ischemia. Abdom Imaging 38, 714–719 (2013). https://doi.org/10.1007/s00261-012-9975-2

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  • DOI: https://doi.org/10.1007/s00261-012-9975-2

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