INTESTINAL REVASCULARIZATION IN ACUTE MESENTERIC ISCHEMIA: CLINICAL REPORTS
DOI:
https://doi.org/10.11603/2414-4533.2025.1.15123Keywords:
acute mesenteric ischemia, intestinal revascularization, superior mesenteric artery embolectomyAbstract
The aim of the work – to demonstrate the clinical cases of successful intestinal revascularization in acute mesenteric ischemia (AMI), that prevented bowel necrosis and avoided its resection, as well as to identify factors that would contribute to the broader spread of these surgical interventions.
Materials and Methods. The clinical cases of two patients who underwent embolectomy from the superior mesenteric artery for AMI are represented.
Results. Successful treatment of AMI depends on early diagnosis and a multidisciplinary approach involving general and vascular surgeons, as well as specialists in functional diagnostics and intensive care. Computed tomography with vascular contrast was used to confirm the diagnosis of acute mesenteric ischemia. Both patients underwent thromboembolectomy from the superior mesenteric artery via open laparotomy. In time performed revascularization preserved the viability and integrity of the intestine, facilitated early restoration of bowel function, and led to patient recovery. However, even after an optimally performed operation, both patients experienced hypotension and renal failure in the early postoperative period, which required appropriate management.
Conclusions. The success of the treatment of acute mesenteric ischemia depends on its early diagnosis. In time performed revascularization not only preserves intestinal integrity and viability, preventing necrosis and peritonitis, but ultimately saves the patient’s life.
References
Kärkkäinen JM. Acute mesenteric ischemia: a challenge for the acute care surgeon. Scand J Surg. 2021; 110(2):150-158. DOI: https://doi.org/10.1177/14574969211007590
Kozak IO. Hostra mezenterialʹna ishemiya: klinika, diahnostyka, likuvannya (ohlyad literatury) [Acute mesenteric ischemia: clinical features, diagnostics, treatment (literature review)]. Klinichna anatomiya ta operatyvna khirurhiya. 2015; 14(2):77-81. Ukranian. DOI: https://doi.org/10.24061/1727-0847.14.2.2015.19
Luther B, Mamopoulos A, Lehmann C, Klar E. The Ongoing Challenge of Acute Mesenteric Ischemia. Visc Med. 2018; 34(3):217-23.
Bala M, Catena F, Kashuk J, De Simone B, et al. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2022 Oct 19; 17(1):54.
Acosta S. Mesenteric ischemia. Curr Opin Crit Care. 2015; 21:171-78. DOI: https://doi.org/10.1097/MCC.0000000000000189
Clair DG, Beach JM. Mesenteric ischemia. N Engl J Med. 2016; 374:959-68. DOI: https://doi.org/10.1056/NEJMra1503884
Acosta-Mérida MA, Marchena-Gómez J, Saavedra-Santana P, et al. Surgical outcomes in acute mesenteric ischemia: has anything changed over the years? World J Surg. 2020; 44(1):100-107. DOI: https://doi.org/10.1007/s00268-019-05183-9
Tran LM, Andraska E, Haga L, et al. Hospital-based delays to revascularization increase risk of postoperative mortality and short bowel syndrome in acute mesenteric ischemia. J Vasc Surg. 2022; 75(4):1323-333. DOI: https://doi.org/10.1016/j.jvs.2021.09.033
Tolonen M, Lemma A, Vikatmaa P, et al. The implementation of a pathway and care bundle for the management of acute occlusive arterial mesenteric ischemia reduced mortality. J Trauma Acute Care Surg. 2021; 91(3):480-88. DOI: https://doi.org/10.1097/TA.0000000000003305
Robles-Martín ML, Reyes-Ortega JP, Rodríguez-Morata A. A Rare Case of Ischemia-Reperfusion Injury After Mesenteric Revascularization. Vasc Endovascular Surg. 2019 Jul; 53(5):424-28. DOI: https://doi.org/10.1177/1538574419839547
Kühn F, Schiergens TS, Klar E. Acute Mesenteric Ischemia. Visc Med. 2020 Aug 4; 36(4):256-62. DOI: https://doi.org/10.1159/000508739
Mishalov VH, Kryvorchuk IH. Metody diahnostyky hostroyi mezenterialʹnoyi ishemiyi ta otsinka yikh efektyvnosti [Methods of diagnosing acute mesenteric ischemia and assessing their effectiveness]. Ukr. med. chasopys. 2013; 4(96):139-41. Ukranian.
Monita MM, Gonzalez L. Acute Mesenteric Ischemia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
Roussel A, Castier Y, Nuzzo A, et al. Revascularization of acute mesenteric ischemia after creation of a dedicated multidisciplinary center. J Vasc Surg. 2015 Nov; 62(5):1251-256. DOI: https://doi.org/10.1016/j.jvs.2015.06.204
Sakamoto T, Kubota T, Funakoshi H, Lefor AK. Multidisciplinary management of acute mesenteric ischemia: Surgery and endovascular intervention. World J Gastrointest Surg. 2021 Aug 27; 13(8):806-13. DOI: https://doi.org/10.4240/wjgs.v13.i8.806
Gries JJ, Virk HU, Chen B, et al. Advancements in Revascularization Strategies for Acute Mesenteric Ischemia: A Comprehensive Review. J Clin Med. 2024; 13:570. DOI: https://doi.org/10.3390/jcm13020570
Hou L, Wang T, Wang J, Zhao J, Yuan D. Outcomes of different acute mesenteric ischemia therapies in the last 20 years: A meta-analysis and systematic review. Vascular. 2022 Aug; 30(4):669-80. DOI: https://doi.org/10.1177/17085381211024503
Luther B, Mamopoulos A, Lehmann C, Klar E. The ongoing challenge of acute mesenteric ischemia. Visc Med. 2018; 34:217-23. DOI: https://doi.org/10.1159/000490318
Danylenko I. A. Likuvannya patsiyentiv z hostrym porushennyamy mezenterialʹnoho krovoobihu (ohlyad literatury) [Treatment of patients with acute disorders of mesenteric circulation (literature review)]. Visnyk SumDU. Seriya Medytsyna. 2010; 2:64-76. Ukranian.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 А. Р. ВАЙДА
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
