Acute mesenteric ischemia : guidelines of the World Society of Emergency Surgery

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Bala , M , Kashuk , J , Moore , E E , Kluger , Y , Biffl , W , Gomes , C A , Ben-Ishay , O , Rubinstein , C , Balogh , Z J , Civil , I , Coccolini , F , Leppaniemi , A , Peitzman , A , Ansaloni , L , Sugrue , M , Sartelli , M , Di Saverio , S , Fraga , G P & Catena , F 2017 , ' Acute mesenteric ischemia : guidelines of the World Society of Emergency Surgery ' , World journal of emergency surgery , vol. 12 , 38 . https://doi.org/10.1186/s13017-017-0150-5

Title: Acute mesenteric ischemia : guidelines of the World Society of Emergency Surgery
Author: Bala, Miklosh; Kashuk, Jeffry; Moore, Ernest E.; Kluger, Yoram; Biffl, Walter; Gomes, Carlos Augusto; Ben-Ishay, Offir; Rubinstein, Chen; Balogh, Zsolt J.; Civil, Ian; Coccolini, Federico; Leppaniemi, Ari; Peitzman, Andrew; Ansaloni, Luca; Sugrue, Michael; Sartelli, Massimo; Di Saverio, Salomone; Fraga, Gustavo P.; Catena, Fausto
Other contributor: University of Helsinki, II kirurgian klinikka



Date: 2017-08-07
Language: eng
Number of pages: 11
Belongs to series: World journal of emergency surgery
ISSN: 1749-7922
DOI: https://doi.org/10.1186/s13017-017-0150-5
URI: http://hdl.handle.net/10138/217901
Abstract: Acute mesenteric ischemia (AMI) is typically defined as a group of diseases characterized by an interruption of the blood supply to varying portions of the small intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process will eventuate in life threatening intestinal necrosis. The incidence is low, estimated at 0.09-0.2% of all acute surgical admissions. Therefore, although the entity is an uncommon cause of abdominal pain, diligence is always required because if untreated, mortality has consistently been reported in the range of 50%. Early diagnosis and timely surgical intervention are the cornerstones of modern treatment and are essential to reduce the high mortality associated with this entity. The advent of endovascular approaches in parallel with modern imaging techniques may provide new options. Thus, we believe that a current position paper from World Society of Emergency Surgery (WSES) is warranted, in order to put forth the most recent and practical recommendations for diagnosis and treatment of AMI. This review will address the concepts of AMI with the aim of focusing on specific areas where early diagnosis and management hold the strongest potential for improving outcomes in this disease process. Some of the key points include the prompt use of CT angiography to establish the diagnosis, evaluation of the potential for revascularization to re-establish blood flow to ischemic bowel, resection of necrotic intestine, and use of damage control techniques when appropriate to allow for re-assessment of bowel viability prior to definitive anastomosis and abdominal closure.
Subject: Mesenteric ischemia
Mesenteric arterial occlusion
Mesenteric angiography
Mesenteric artery stenting
Small bowel ischemia
Guidelines
Recommendations
DAMAGE CONTROL SURGERY
ACUTE THROMBOEMBOLIC OCCLUSION
MULTIDETECTOR CT ANGIOGRAPHY
MEDIATED FASCIAL TRACTION
ASSISTED WOUND CLOSURE
INTESTINAL ISCHEMIA
DIAGNOSTIC-ACCURACY
PERITONEAL RESUSCITATION
ENDOVASCULAR TREATMENT
VENOUS THROMBOSIS
3126 Surgery, anesthesiology, intensive care, radiology
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