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Modern treatment of acute mesenteric ischaemia
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.ORCID iD: 0000-0001-6561-9734
2014 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 101, no 1, E100-E108 p.Article, review/survey (Refereed) Published
Abstract [en]

Background: Diagnosis of acute mesenteric ischaemia in the early stages is now possible with modern computed tomography (CT), using intravenous contrast enhancement and imaging in the arterial and/or portal venous phase. The availability of CT around the clock means that more patients with acute mesenteric ischaemia may be treated with urgent intestinal revascularization.

Methods: This was a review of modern treatment strategies for acute mesenteric ischaemia.

Results: Endovascular therapy has become an important alternative, especially in patients with acute thrombotic superior mesenteric artery (SMA) occlusion, where the occlusive lesion can be recanalized either antegradely from the femoral or brachial artery, or retrogradely from an exposed SMA after laparotomy, and stented. Aspiration embolectomy, thrombolysis and open surgical embolectomy, followed by on-table angiography, are the treatment options for embolic SMA occlusion. Endovascular therapy may be an option in the few patients with mesenteric venous thrombosis who do not respond to anticoagulation therapy. Laparotomy is needed to evaluate the extent and severity of visceral organ ischaemia, which is treated according to the principles of damage control surgery.

Conclusion: Modern treatment of acute mesenteric ischaemia involves a specialized approach that considers surgical and, increasingly, endovascular options for best outcomes. Endovascular increasingly important

Place, publisher, year, edition, pages
2014. Vol. 101, no 1, E100-E108 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-216244DOI: 10.1002/bjs.9330ISI: 000328415300013OAI: oai:DiVA.org:uu-216244DiVA: diva2:689362
Available from: 2014-01-20 Created: 2014-01-20 Last updated: 2015-02-19Bibliographically approved

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Björck, Martin
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