Karthik Gnanapandithan1, Paul Feuerstadt2,3. 1. Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA. 2. Division of Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA. pfeuerstadt@gastrocenter.org. 3. Gastroenterology Center of Connecticut, Yale University School of Medicine, Hamden, CT, USA. pfeuerstadt@gastrocenter.org.
Abstract
PURPOSE OF REVIEW: Mesenteric ischemia (MI), both acute (AMI) and chronic (CMI), is a challenging diagnosis to make, and early diagnosis and treatment are vital to improve outcomes. This manuscript summarizes the most up to date information on diagnosis and treatment of these disorders. RECENT FINDINGS: There have been several significant advancements in the computed tomography (CT) diagnostic imaging as well as medical and endovascular management of AMI and CMI. In appropriate populations, endovascular interventions appear superior to open surgical management with lower mortality, morbidity, and cost of care. Efficient clinical identification and targeted testing are essential to diagnose AMI and CMI. Aggressive resuscitation and early endovascular (or in select cases, surgical) intervention improve outcomes in those with AMI. In those with CMI, considering this on the differential diagnosis and imaging appropriately can identify those that might benefit from intervention and halt progression to acute episodes.
PURPOSE OF REVIEW: Mesenteric ischemia (MI), both acute (AMI) and chronic (CMI), is a challenging diagnosis to make, and early diagnosis and treatment are vital to improve outcomes. This manuscript summarizes the most up to date information on diagnosis and treatment of these disorders. RECENT FINDINGS: There have been several significant advancements in the computed tomography (CT) diagnostic imaging as well as medical and endovascular management of AMI and CMI. In appropriate populations, endovascular interventions appear superior to open surgical management with lower mortality, morbidity, and cost of care. Efficient clinical identification and targeted testing are essential to diagnose AMI and CMI. Aggressive resuscitation and early endovascular (or in select cases, surgical) intervention improve outcomes in those with AMI. In those with CMI, considering this on the differential diagnosis and imaging appropriately can identify those that might benefit from intervention and halt progression to acute episodes.
Entities:
Keywords:
Acute mesenteric ischemic; Chronic mesenteric ischemia; Non-occlusive mesenteric ischemia; Superior mesenteric artery embolism; Superior mesenteric artery thrombosis
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