HEMOSTATIC ALTERATIONS IN ACUTE MESENTERIC ISCHEMIA
DOI:
https://doi.org/10.11603/2414-4533.2026.1.16063Keywords:
acute mesenteric ischemia, hemostasis, D-dimer, reperfusion syndrome, sepsis-induced coagulopathy, mesenteric artery embolismAbstract
The aim of the work: to investigate the dynamics of the coagulation and fibrinolytic systems in patients with acute mesenteric ischemia depending on the etiology and duration of the disease to determine their prognostic role.
Materials and Methods. A retrospective analysis of hemostatic parameters (fibrinogen, prothrombin time, INR, D-dimer, total fibrinolytic activity) and inflammatory markers (procalcitonin, CRP) was conducted in patients with acute mesenteric ischemia (AMI). Participants were grouped by etiological factor (embolism, thrombosis), duration of ischemia, and the nature of surgical intervention.
Results. It was established that AMI is accompanied by stage-specific changes in the hemostatic system. D-dimer was identified as the most dynamic marker, its level directly correlating with the depth of ischemic damage. In cases of embolism, changes in the coagulation system were more pronounced compared to mesenteric artery thrombosis. In the postoperative period following successful revascularization, a "wash-out" effect was recorded (secondary increase in D-dimer and CRP), confirming the development of reperfusion syndrome even when intestinal viability was preserved. A 24-hour time threshold was determined as a critical limit, beyond which hypercoagulation processes shift toward decompensated sepsis-induced consumption coagulopathy with depletion of the fibrinogen synthetic reserve.
Conclusions. Hemostatic system dysfunction is an integral link in the pathogenesis of AMI. The nature of coagulation and fibrinolytic system disturbances depends on the etiology of the occlusion and the duration of the disease. Monitoring hemostatic parameters and inflammatory markers in dynamics allows for predicting intestinal viability, assessing the severity of reperfusion syndrome, and verifying the transition of ischemia into the irreversible stage of sepsis-induced coagulopathy.
Received: 21.01.2026 | Revised: 13.02.2026 | Accepted: 20.02.2026
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