80% of acute mesenteric ischemia cases result in mortality because of missed diagnosis.
Acute mesenteric ischemia is a life-threatening vascular emergency that requires early diagnosis and intervention to adequately restore mesenteric blood flow and to prevent bowel necrosis and patient death. The underlying cause is varied, and the prognosis depends on the precise pathologic findings.
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./
Diagnosis is challenging secondary to the rarity of the disease, its nonspecific clinical presentation, and often subtle or non-specific imaging findings. Consequently, a high index of suspicion on the part of the clinician and the radiologist, as well as familiarity with the spectrum of imaging findings associated with mesenteric ischemia, is required to ensure prompt recognition of the disease.
In spite of all our technological advances in medicine, mesenteric ischemia remains a very difficult disease process to identify early. Often patients will present with vague and variable signs and symptoms such as poorly localized abdominal pain, nausea, vomiting, and diarrhea. These non-specific signs and symptoms can be associated with an extremely wide variety of abdominal pathologies including, but not limited to, abdominal aortic aneurysm, volvulus, perforated viscus, incarcerated hernia, appendicitis, biliary colic, and renal colic.
Mesenteric ischemia can come on suddenly or build slowly and become an ongoing health issue. It is part of a systemic disease process known as peripheral vascular disease or peripheral artery disease (PAD).
This consensus paper was written with the participation of physicians from all of the involved specialties for the purpose of improving outcomes. Mesenteric ischemia must be recognized as a vascular emergency requiring rapid and efficient clinical evaluation and treatment.
Sudden loss of blood flow to the small intestine (acute mesenteric ischemia) from a blood clot requires immediate surgery. Mesenteric ischemia that develops over time (chronic) is treated with angioplasty or open surgery.