Acute Mesenteric Ischemia: a Disease Still Challenging Surgeons

Abstract

Acute mesenteric ischemia is a medical emergency that has a high incidence of morbidity and mortality. The most effective way to reduce its consequences is to establish early diagnosis and revascularization. Here, we aimed to present our management and outcome. In this case series analysis, patients with acute mesenteric ischemia were examined from January 2013 to September 2018. Thromboembolectomy was applied by using a 2-3 French sized Fogarty catheter until the superior mesenteric artery flow was restored. Endarterectomy and saphenous vein patchplasty were preferred in atherosclerotic arteries. Nineteen patients were examined. Hypertension (63.2%) and atrial fibrillation (57.9%) were the most common seen comorbid factors. After embolectomy, arterial pulsation came back in 17 (89.5%) patients. Two patients had saphenous vein bypass due to the severe atherosclerosis of the mesenteric artery. Seven (36.8%) patients died on early postoperative period. Multiorgan failure developed in 2 (10.5%) patients. The survival rate was 42.1% in 46 SD17.3 months follow-up. Acute mesenteric ischemia has high mortality and morbidity because of the local and systemic effects of comorbid diseases and intestinal ischemia. The main goals of treatment should be maintaining body auto-regulation, establishing revascularization of the ischemic intestine and removing necrotic tissues.