Acute mesenterio ischemia (AMI) is a clínical entity of historically high mortality, diagnosed and treated by the general surgeon af the emergency service.
The objecfive of this sfudy is to know the incidence and efiology of mesenterio ischemia in our cenfer; to present the ways of diagnosing and treatment to know its evolution and mortality.
For this purpose a refrospective study was carried out, describing 78 coses of AMI handled in our emergency service from December 1989 fo February 2000.
The average age was 69.6 years, wifh 52% males. The diagnoses on admission, in decreasing order, were: intestinal obstrucfion, mesenterio ischemia, diffuse peritonitis, pancreatitis. The most frequent associated pathology was the cardiovascular type (arterial hypertension, auricular fibrillation, acute myocardial infarct and congestiva cardiac insufficiency). The predominant clinical symptom complex was abdominal pain, emesis, signs of peritoneal obstruction and irritation, leukocytosis, and acidosis. The frequency of embolus, arterial thrombosis and venous thrombosis is similar in this study, in 30º/o of fhe cases a diagnosis was not determined. The most frequent way of diagnosing was intraoperative. The CAT sean and the ECO DUPLEX allowed the earliest diagnosis intestinal resection the most frequent intervention (58%). Only an exploratory laparoscopy was performed in a third of the patients.
due to fhEl extent of the disease. The intestinal necrosis involves mainly jejuno-ileum (12%). The global mortality was 71. 8%, and the mortality of those subjected to surgery 81. 5%. Patients with venous thrombosis compromising abdomen and patients with severa shock were not subjected to surgery.
The AMI is a pathology with high mortality attended at emergency service by the general surgeon. AMI should be suspected in any symptom complex with abdominal pain of unclear origin, and which also shows signs of risk factors (cardiovascular, thrombophilia).
The early study by means of an angiogram and/or an abdominal CAT sean is an important factor for claritying the etiology before surgery. The use of an angiogram would also allow the intra-arterial infusion of vasodilators (papaverine) which wou/d be the treatment for certain cases (NOMIJ and would allow less resectioning in other cases (thrombosis and arterial embolus). According to a literature review, making the compromised vein permeable (embolectomy, aorticmesenteric bypass) is recommended so as to diminish the intestinal ischemia and to lower the historical mortality.
Bermudez, C. ., Mora, C. ., Lui, . A. ., Salguero, J. ., & Kriman, J. . (2002). Isquemia mesentérica aguda experiencia de 10 años. Revista Hospital Clínico Universidad De Chile, 13(1), pp. 8–13. https://doi.org/10.5354/2735-7996.2002.79677
