Non-occlusive mesenteric ischemia in critically ill patients: does bedside laparoscopy offer any real benefit?

Abstract. Non-occlusive mesenteric ischemia in critically ill patients still has a poor prognosis. Despite several established risk factors, the interaction between clinical conditions and perfusion mismatch often leads to progressive organ failure. Workup is challenging because of the absence of ty...

Full description

Saved in:
Bibliographic Details
Main Authors: Mirko Barone, Regina Frontera, Rita Vaia Liouras, Massimo Ippoliti, Luca Serano, Carmine Giovanni Iovino, Ivan Dell’Atti, Luigi Vetrugno, Felice Mucilli, Salvatore Maurizio Maggiore
Format: Article
Language:English
Published: Wolters Kluwer Health/LWW 2024-12-01
Series:Emergency and Critical Care Medicine
Online Access:http://journals.lww.com/10.1097/EC9.0000000000000107
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract. Non-occlusive mesenteric ischemia in critically ill patients still has a poor prognosis. Despite several established risk factors, the interaction between clinical conditions and perfusion mismatch often leads to progressive organ failure. Workup is challenging because of the absence of typical abdominal signs and symptoms due to sedation, poor reactivity, need for ventilation, and confounding comorbidities. Moreover, imaging has poor specificity with findings often inconclusive. A bedside exploratory laparoscopy, as a complementary strategy, would allow for early and prompt diagnosis. Limits of a minimally invasive surgical rationale lie upon the effects of pneumoperitoneum induction, surgical stress, logistical resources, expertise, and costs.
ISSN:2097-0617
2693-860X