Factors affecting treatment outcome in patients with Acute Mesenteric Ischemia

ABSTRACT

Background: Acute mesenteric ischemia (AMI) is a syndrome caused by inadequate blood flow through the mesenteric vessels, resulting in ischemia and eventual gangrene of the bowel wall. It may be classified as either arterial or venous. The purpose was to investigate the factors affecting the treatment outcome of the patients presenting with acute mesenteric ischemia.

Methods: This study included 50 adult patients admitted with AMI at the Alexandria Main University Hospital from January 2014 to January 2015. Analysis of the factors, Age, Gender, Drug history, Cardiovascular and Renal disease, Vital signs (blood pressure, pulse, temperature, and respiratory rate), laboratory investigations  and line of treatment in relation to the outcome.

Results: In this study, 50 patients were enrolled, 40 female patients and 10 were males. The mortality rate was noticed more in the age above 50 years with history of cardiovascular disease or renal disease and systolic blood pressure less than 90 mmHg on admission.

Conclusion: The incidence of AMI is more common above age of 50 years. Abdominal tenderness is the most common findings in patients presented with AMI.

Key words – ischemia, vascular occlusion

REFERENCES

1. Brandt LJ, Boley SJ. AGA technical review on intestinal ischemia. American Gastrointestinal Association. Gastroenterology 2000;118:954-68.
2. American gastroenterological association medical position statement: guidelines on intestinal ischemia. Gastroenterology 2000;118:951-3.
3. Greenwald DA, Brandt LJ, Reinus JF. Ischemic bowel disease in the elderly. Gastroenterol Clin North Am 2001;30:445-73.
4. McKinsey JF, Gewertz BL. Acute mesenteric ischemia. Surg Clin North Am 1997;77:307-18.
5. Sachs SM, Morton JH, Schwartz SI. Acute mesenteric ischemia. Surgery 1982; 92(4):646-53.
6. Kougias P, Lau D, El Sayed HF, Zhou W, Huynh TT, Lin PH. Determinants of mortality and treatment outcome following surgical interventions for acute mesenteric ischemia. J Vasc Surg 2007;46:467-74.
7. Park WM, Gloviczki P, Cherry KJ Jr, Hallett JW Jr, Bower TC, Panneton JM, et al. Contemporary management of acute mesenteric ischemia: Factors associated with survival. J Vasc Surg 2002;35:445-52.
8. Alhan E, Usta A, Cekic A, Saglam K, Turkyilmaz S, Cinel A. A study on 107 patients with acute mesenteric ischemia over 30 years. Int J Surg 2012;10:510-3.
9. Aliosmanoglu I, Gul M, Kapan M, Arikanoglu Z, Taskesen F, Basol O, et al. Risk factors effecting mortality in acute mesenteric ischemia and mortality rates: a single center experience. Int Surg 2013; 98(1):76-81.
10. Brunaud L, Antunes L, Collinet-Adler S, Marchal F, Ayav A, Bresler L, et al. Acute mesenteric venous thrombosis: case for nonoperative management. J Vasc Surg 2001;34:673-9.
11. Kirkpatrick ID, Greenberg HM. Gastrointestinal complications in the neutropenic patient: characterization and differentiation with abdominal CT. Radiology 2003;226(3):668-74.
12. Sateesh Pujari, & Estari Mamidala. (2015). Anti-diabetic activity of Physagulin-F isolated from Physalis angulata fruits. The American Journal of Science and Medical Research, 1(2), 53–60. https://doi.org/10.5281/zenodo.7352308
13. Federle MP, Chun G, Jeffrey RB, Rayor R. Computed tomographic findings in bowel infarction. AJR Am J Roentgenol 1984;142:91-5.
14. Klar E, Rahmanian PB, Bucker A, Hauenstein K, Jauch KW, Luther B. Acute mesenteric ischemia: a vascular emergency. Dtsch Arztebl Int 2012;109:249-56.
15. Stamatakos M, Stefanaki C, Mastrokalos D, Arampatzi H, Safioleas P, Chatziconstantinou C, et al. Mesenteric ischemia: still a deadly puzzle for the medical community. Tohoku J Exp Med 2008;216:197-204.
16. Finucane PM, Arunachalam T, O'Dowd J, Pathy M. Acute Mesenteric Infarction in Elderly Pati. J Am Geriatr Soc 1989;37:355-8.