Clinical aspects of acute mesenteric ischaemia

Acute mesenteric ischaemia (AMI) is a serious disease with mortality between 50 and 80 %. Oxidative stress plays a major role in the pathophysiology of AMI. AMI should be considered for any acute abdominal pain that requires analgesia with morphine and for which no other obvious aetiology is found....

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Main Authors: Matković Zoran, Maličević Uglješa, Gajić-Bojić Milica, Krivokuća Aleksandra, Đukanović Đorđe, Đekić-Matković Nataša, Aleksić Zoran
Format: Article
Language:English
Published: Medical Society of the Republic of Srpska, Banja Luka, University of Banja Luka. Faculty of Medicine 2024-01-01
Series:Scripta Medica
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Online Access:https://scindeks-clanci.ceon.rs/data/pdf/2490-3329/2024/2490-33292405617M.pdf
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author Matković Zoran
Maličević Uglješa
Gajić-Bojić Milica
Krivokuća Aleksandra
Đukanović Đorđe
Đekić-Matković Nataša
Aleksić Zoran
author_facet Matković Zoran
Maličević Uglješa
Gajić-Bojić Milica
Krivokuća Aleksandra
Đukanović Đorđe
Đekić-Matković Nataša
Aleksić Zoran
author_sort Matković Zoran
collection DOAJ
description Acute mesenteric ischaemia (AMI) is a serious disease with mortality between 50 and 80 %. Oxidative stress plays a major role in the pathophysiology of AMI. AMI should be considered for any acute abdominal pain that requires analgesia with morphine and for which no other obvious aetiology is found. CT is the main diagnostic procedure to confirm the diagnosis of AMI. There is no specific diagnostic biomarker for AMI that can be used in routine practice. AMI is an urgent diagnostic and therapeutic situation. Treatment of AMI includes a protocol combining digestive rest, curative anticoagulant, antiplatelet, antibiotic therapy, arterial revascularisation to salvage viable bowel and resection of necrotic digestive segments. The strategy of revascularisation depends on the mechanism of arterial occlusion, the morphological appearance of the lesions and the indications for exploratory laparotomy. Endovascular and open surgical techniques can be combined and complemented. Open surgical revascularisation is indicated in case of failure or impossibility of endovascular revascularisation and in case of need for laparotomy. Early diagnosis and timely surgical intervention are the cornerstones of modern treatment to reduce the high mortality of AMI. The emergence of endovascular approaches and modern imaging techniques is developing and providing new treatment options. A multidisciplinary approach based on early diagnosis and treatment is necessary.
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spelling doaj-art-c74ca97f0f44460b99e699c0a8d5ac792025-08-20T02:18:25ZengMedical Society of the Republic of Srpska, Banja Luka, University of Banja Luka. Faculty of MedicineScripta Medica2490-33292303-79542024-01-0155562363510.5937/scriptamed55-505142490-33292405617MClinical aspects of acute mesenteric ischaemiaMatković Zoran0https://orcid.org/0000-0002-5216-5793Maličević Uglješa1https://orcid.org/0009-0004-7649-186XGajić-Bojić Milica2https://orcid.org/0009-0006-8433-7808Krivokuća Aleksandra3https://orcid.org/0009-0004-9431-3848Đukanović Đorđe4https://orcid.org/0000-0002-9887-9695Đekić-Matković Nataša5https://orcid.org/0009-0005-9731-6320Aleksić Zoran6https://orcid.org/0009-0002-7047-3500General Hospital Doboj, Doboj, The Republic of Srpska, Bosnia and HerzegovinaUniversity of Banja Luka, Faculty of Medicine, Centre for Biomedical Research, Banja Luka, The Republic of Srpska, Bosnia and HerzegovinaUniversity of Banja Luka, Faculty of Medicine, Centre for Biomedical Research, Banja Luka, The Republic of Srpska, Bosnia and HerzegovinaUniversity of Banja Luka, Faculty of Medicine, Centre for Biomedical Research, Banja Luka, The Republic of Srpska, Bosnia and HerzegovinaUniversity of Banja Luka, Faculty of Medicine, Centre for Biomedical Research, Banja Luka, The Republic of Srpska, Bosnia and HerzegovinaGeneral Hospital Doboj, Doboj, The Republic of Srpska, Bosnia and HerzegovinaUniversity Clinical Centre of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and HerzegovinaAcute mesenteric ischaemia (AMI) is a serious disease with mortality between 50 and 80 %. Oxidative stress plays a major role in the pathophysiology of AMI. AMI should be considered for any acute abdominal pain that requires analgesia with morphine and for which no other obvious aetiology is found. CT is the main diagnostic procedure to confirm the diagnosis of AMI. There is no specific diagnostic biomarker for AMI that can be used in routine practice. AMI is an urgent diagnostic and therapeutic situation. Treatment of AMI includes a protocol combining digestive rest, curative anticoagulant, antiplatelet, antibiotic therapy, arterial revascularisation to salvage viable bowel and resection of necrotic digestive segments. The strategy of revascularisation depends on the mechanism of arterial occlusion, the morphological appearance of the lesions and the indications for exploratory laparotomy. Endovascular and open surgical techniques can be combined and complemented. Open surgical revascularisation is indicated in case of failure or impossibility of endovascular revascularisation and in case of need for laparotomy. Early diagnosis and timely surgical intervention are the cornerstones of modern treatment to reduce the high mortality of AMI. The emergence of endovascular approaches and modern imaging techniques is developing and providing new treatment options. A multidisciplinary approach based on early diagnosis and treatment is necessary.https://scindeks-clanci.ceon.rs/data/pdf/2490-3329/2024/2490-33292405617M.pdfmesenteric ishaemia, acuteoxidative stressmesenteric vascular occlusiondiagnostic imagingcttreatment
spellingShingle Matković Zoran
Maličević Uglješa
Gajić-Bojić Milica
Krivokuća Aleksandra
Đukanović Đorđe
Đekić-Matković Nataša
Aleksić Zoran
Clinical aspects of acute mesenteric ischaemia
Scripta Medica
mesenteric ishaemia, acute
oxidative stress
mesenteric vascular occlusion
diagnostic imaging
ct
treatment
title Clinical aspects of acute mesenteric ischaemia
title_full Clinical aspects of acute mesenteric ischaemia
title_fullStr Clinical aspects of acute mesenteric ischaemia
title_full_unstemmed Clinical aspects of acute mesenteric ischaemia
title_short Clinical aspects of acute mesenteric ischaemia
title_sort clinical aspects of acute mesenteric ischaemia
topic mesenteric ishaemia, acute
oxidative stress
mesenteric vascular occlusion
diagnostic imaging
ct
treatment
url https://scindeks-clanci.ceon.rs/data/pdf/2490-3329/2024/2490-33292405617M.pdf
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AT krivokucaaleksandra clinicalaspectsofacutemesentericischaemia
AT đukanovicđorđe clinicalaspectsofacutemesentericischaemia
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