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...

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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
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author Mirko Barone
Regina Frontera
Rita Vaia Liouras
Massimo Ippoliti
Luca Serano
Carmine Giovanni Iovino
Ivan Dell’Atti
Luigi Vetrugno
Felice Mucilli
Salvatore Maurizio Maggiore
author_facet Mirko Barone
Regina Frontera
Rita Vaia Liouras
Massimo Ippoliti
Luca Serano
Carmine Giovanni Iovino
Ivan Dell’Atti
Luigi Vetrugno
Felice Mucilli
Salvatore Maurizio Maggiore
author_sort Mirko Barone
collection DOAJ
description 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.
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issn 2097-0617
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publishDate 2024-12-01
publisher Wolters Kluwer Health/LWW
record_format Article
series Emergency and Critical Care Medicine
spelling doaj-art-729cb4e1d7af4531b8a8961a774acbc52025-08-20T02:26:10ZengWolters Kluwer Health/LWWEmergency and Critical Care Medicine2097-06172693-860X2024-12-014413914210.1097/EC9.0000000000000107202412000-00001Non-occlusive mesenteric ischemia in critically ill patients: does bedside laparoscopy offer any real benefit?Mirko Barone0Regina Frontera1Rita Vaia Liouras2Massimo Ippoliti3Luca Serano4Carmine Giovanni Iovino5Ivan Dell’Atti6Luigi Vetrugno7Felice Mucilli8Salvatore Maurizio Maggiore9a Department of General and Thoracic Surgery, SS. Annunziata University Hospital, Chieti, Italyb Department of Anaesthesiology and Intensive Care Medicine, SS. Annunziata University Hospital, Chieti, Italyb Department of Anaesthesiology and Intensive Care Medicine, SS. Annunziata University Hospital, Chieti, Italya Department of General and Thoracic Surgery, SS. Annunziata University Hospital, Chieti, Italyb Department of Anaesthesiology and Intensive Care Medicine, SS. Annunziata University Hospital, Chieti, Italyb Department of Anaesthesiology and Intensive Care Medicine, SS. Annunziata University Hospital, Chieti, Italyb Department of Anaesthesiology and Intensive Care Medicine, SS. Annunziata University Hospital, Chieti, Italyb Department of Anaesthesiology and Intensive Care Medicine, SS. Annunziata University Hospital, Chieti, Italya Department of General and Thoracic Surgery, SS. Annunziata University Hospital, Chieti, Italyb Department of Anaesthesiology and Intensive Care Medicine, SS. Annunziata University Hospital, Chieti, ItalyAbstract. 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.http://journals.lww.com/10.1097/EC9.0000000000000107
spellingShingle Mirko Barone
Regina Frontera
Rita Vaia Liouras
Massimo Ippoliti
Luca Serano
Carmine Giovanni Iovino
Ivan Dell’Atti
Luigi Vetrugno
Felice Mucilli
Salvatore Maurizio Maggiore
Non-occlusive mesenteric ischemia in critically ill patients: does bedside laparoscopy offer any real benefit?
Emergency and Critical Care Medicine
title Non-occlusive mesenteric ischemia in critically ill patients: does bedside laparoscopy offer any real benefit?
title_full Non-occlusive mesenteric ischemia in critically ill patients: does bedside laparoscopy offer any real benefit?
title_fullStr Non-occlusive mesenteric ischemia in critically ill patients: does bedside laparoscopy offer any real benefit?
title_full_unstemmed Non-occlusive mesenteric ischemia in critically ill patients: does bedside laparoscopy offer any real benefit?
title_short Non-occlusive mesenteric ischemia in critically ill patients: does bedside laparoscopy offer any real benefit?
title_sort non occlusive mesenteric ischemia in critically ill patients does bedside laparoscopy offer any real benefit
url http://journals.lww.com/10.1097/EC9.0000000000000107
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