Materiały źródłowe

• #1 Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-022-00443-x

  Acute mesenteric ischemia (AMI) is a group of diseases characterized by an interruption of the blood supply to varying portions of the intestine, leading to ischemia and secondary inflammatory changes. The incidence is low, estimated at 0.090.2% of all acute surgical admissions, but increases with age. […] Although the entity is an uncommon cause of abdominal pain, diligence is required because if untreated, mortality remains in the range of 50%. Early diagnosis and timely surgical intervention are the cornerstones of modern treatment to reduce the high mortality associated with this entity. […] The overall incidence is low (0.090.2% of all acute admissions to emergency departments), representing an infrequent cause of abdominal pain, but a common cause of emergent intestinal resection. Prompt diagnosis and intervention are essential to reduce the mortality rates that exceed 50%.

• #2 Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-017-0150-5

  Severe abdominal pain out of proportion to physical examination findings should be assumed to be AMI until disproven. (Recommendation 1B) […] The overall incidence is low (0.09 to 0.2% of all acute admissions to emergency departments), representing an uncommon cause of abdominal pain. […] Prompt diagnostic and intervention are essential to reduce the high mortality rates (50 to 80%). […] There are currently no level 1 evidence to guide the evaluation and treatment of suspected AMI, and the published literature contains primarily institutional reviews, case series and personal recommendations with no clearly defined treatment guidelines. […] Non-occlusive mesenteric ischemia (NOMI) should be suspected in critically ill patients with abdominal pain or distension requiring vasopressor support and evidence of multi-organ dysfunction. (Recommendation 1B)

• #3 Bowel Ischemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554527/

  Bowel ischemia can classify as small intestine ischemia, which is commonly known as mesenteric ischemia and large intestine ischemia, which generally referred to as colonic ischemia. […] This is an uncommon medical condition, but it has a high mortality rate. […] Bowel ischemia can be classified as small intestine ischemia, which is commonly known as mesenteric ischemia and large intestine ischemia, which generally referred to as colonic ischemia. […] An acute decrease in mesenteric arterial blood flow causes 60% to 70% of patients with mesenteric ischemia. The rest of the causes are related to colonic ischemia and chronic mesenteric ischemia. […] Mesenteric ischemia (MI) accounts for 0.1% of all hospital admissions, despite this being a rare medical condition. It has high mortality rates ranging from 24% to 94%. […] The incidence of colonic ischemia is approximately 16 cases per 100,000 person-years, and it is increasing over time. […] Ischemic colitis is reported for 1 in 2000 hospital admissions. […] This medical condition is more common in females.

• #4 Biochemical markers of acute intestinal ischemia: possibilities and limitations

  https://atm.amegroups.org/article/view/20595/html

  Acute intestinal ischemia is a relative rare abdominal emergency, associated with considerably high morbidity and mortality rates. […] The mortality usually ranges between 60-80% depending on etiology, age and diagnostic delay. […] Overall, this condition represents less than 1% of all acute admissions to emergency departments, but a rapid diagnosis and therapeutic management are compelling for adequately restoring blood flow and preventing intestine necrosis, up to patient death. […] Despite ample research in this field, early, sensitive and specific biomarkers of acute intestinal ischemia have not been identified so far. […] The aim of this narrative review is hence to provide an overview on traditional laboratory biomarkers of acute intestinal ischemia and summarize current evidence regarding some emerging and potentially useful biomarkers.

• #5

  https://link.springer.com/article/10.1007/s00268-022-06805-5

  There is a lack of population-based studies on acute mesenteric ischemia (AMI). […] We have therefore performed a nationwide epidemiological study in Estonia, addressing incidence, demographics, interventions and mortality of AMI. […] Overall, 577 cases of AMI were identifiedan annual incidence of 8.7 per 100,000. […] The population-based annual incidence of AMI in Estonia was 8.7 per 100,000 during the study period. […] The overall hospital mortality and 1 year mortality were 64% and 74%, respectively. […] In the 53% of patients who received active treatment hospital mortality was 32% and 1 year all-cause mortality was 51%.

• #6

  https://link.springer.com/article/10.1007/s00268-022-06805-5

  There is a lack of population-based studies on acute mesenteric ischemia (AMI). […] We have therefore performed a nationwide epidemiological study in Estonia, addressing incidence, demographics, interventions and mortality of AMI. […] Overall, 577 cases of AMI were identifiedan annual incidence of 8.7 per 100,000. […] The population-based annual incidence of AMI in Estonia was 8.7 per 100,000 during the study period. […] The overall hospital mortality and 1 year mortality were 64% and 74%, respectively. […] In the 53% of patients who received active treatment hospital mortality was 32% and 1 year all-cause mortality was 51%.

• #7

  https://journals.lww.com/ajg/fulltext/2015/01000/acg_clinical_guideline__epidemiology,_risk.8.aspx

  A recently published population-based study yielded an incidence of 16.3 cases/100,000 person-years with a nearly fourfold increase over 34 years. […] CI occurs in adults of all ages and increases with age, especially after age 49 years. […] CI is more common in women than in men, and 5776% of patients in large series have been female. […] Mortality rates in large series range from 4 to 12%, but inclusion criteria, case ascertainment methods, and rates of comorbidity and surgery in these studies differed. […] Recurrent CI increases over time; for example, estimated cumulative recurrence rates at 1, 23, 4, and 56 years were 3%, 5%, 6%, and 10%, respectively, in one study and 3.3% at 2 years and 7.5% at 5 years in another study. […] Therefore, in any large survey, recurrence will be related to the relative proportions of patients with spontaneous, idiopathic disease and those with illnesses likely to foster recurrence.

• #8 Intestinal Ischemia | Concise Medical Knowledge

  https://www.lecturio.com/concepts/intestinal-ischemia/

  For all types, intestinal ischemia primarily affects adults 60 years of age. […] Ischemic colitis: most common type of intestinal ischemia (approximately 60%-70%). […] Acute mesenteric ischemia: In addition to older adults, may also occur in younger people with atrial fibrillation and hypercoagulable states. […] Mortality rates: Occlusive mesenteric infarction has a mortality rate (approximately 60%). […] Chronic mesenteric ischemia: incidence.

• #9 Bowel Ischaemia | Doctor

  https://patient.info/doctor/bowel-ischaemia

  How common is acute mesenteric ischaemia? (epidemiology) […] This is chiefly a disease of people aged over 50, although younger people with risk factors for mesenteric venous thrombosis (MVT) – eg, atrial fibrillation (AF) – can be affected. The overall incidence is low – around 0.09-0.2% of all hospital admissions – but is a common indication for emergency intestinal resection.1 […] How common is chronic mesenteric ischaemia? (Epidemiology) […] Chronic mesenteric ischaemia has a very low incidence, accounting for less than 1 in 1,000 hospital admissions for abdominal pain.3 […] How common is ischaemic colitis? (Epidemiology) […] The incidence of ischaemic colitis rose from 6.1 cases/100000 person-years in 1976-80 to 22.9/100000 in 2005-09.6 Many mild cases may go unreported. […] Because the most common cause is atheroma of the mesenteric vessels it is mainly a disease of the elderly and is rare before the age of 60. […] The average age for diagnosis is 70. The incidence is likely to increase with the increasing age of the population. The condition is, however, by no means unknown in younger age groups, due to non-cardiovascular causes such as cocaine abuse.

• #10 Bowel Ischemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554527/

  Bowel ischemia can classify as small intestine ischemia, which is commonly known as mesenteric ischemia and large intestine ischemia, which generally referred to as colonic ischemia. […] This is an uncommon medical condition, but it has a high mortality rate. […] Bowel ischemia can be classified as small intestine ischemia, which is commonly known as mesenteric ischemia and large intestine ischemia, which generally referred to as colonic ischemia. […] An acute decrease in mesenteric arterial blood flow causes 60% to 70% of patients with mesenteric ischemia. The rest of the causes are related to colonic ischemia and chronic mesenteric ischemia. […] Mesenteric ischemia (MI) accounts for 0.1% of all hospital admissions, despite this being a rare medical condition. It has high mortality rates ranging from 24% to 94%. […] The incidence of colonic ischemia is approximately 16 cases per 100,000 person-years, and it is increasing over time. […] Ischemic colitis is reported for 1 in 2000 hospital admissions. […] This medical condition is more common in females.

• #11 Ischemic colitis – Wikipedia

  https://en.wikipedia.org/wiki/Ischemic_colitis

  The exact incidence of ischemic colitis is difficult to estimate, as many patients with mild ischemia may not seek medical attention. Ischemic colitis is responsible for about 1 in 2000 hospital admissions and is seen on about 1 in 100 endoscopies. Men and women are affected equally; ischemic colitis is a disease of the elderly, with more than 90% of cases occurring in people over the age of 60.

• #12 Bowel Ischaemia | Doctor

  https://patient.info/doctor/bowel-ischaemia

  How common is acute mesenteric ischaemia? (epidemiology) […] This is chiefly a disease of people aged over 50, although younger people with risk factors for mesenteric venous thrombosis (MVT) – eg, atrial fibrillation (AF) – can be affected. The overall incidence is low – around 0.09-0.2% of all hospital admissions – but is a common indication for emergency intestinal resection.1 […] How common is chronic mesenteric ischaemia? (Epidemiology) […] Chronic mesenteric ischaemia has a very low incidence, accounting for less than 1 in 1,000 hospital admissions for abdominal pain.3 […] How common is ischaemic colitis? (Epidemiology) […] The incidence of ischaemic colitis rose from 6.1 cases/100000 person-years in 1976-80 to 22.9/100000 in 2005-09.6 Many mild cases may go unreported. […] Because the most common cause is atheroma of the mesenteric vessels it is mainly a disease of the elderly and is rare before the age of 60. […] The average age for diagnosis is 70. The incidence is likely to increase with the increasing age of the population. The condition is, however, by no means unknown in younger age groups, due to non-cardiovascular causes such as cocaine abuse.

• #13

  https://journals.lww.com/ctg/fulltext/2020/08000/the_incidence_of_chronic_mesenteric_ischemia_in.6.aspx

  This study aimed to determine the incidence of chronic mesenteric ischemia (CMI) and to examine the influence of the etiological cause, location, and severity of a mesenteric artery stenosis on the probability of having CMI. […] The incidence of CMI is presumed to be very low, which may result in insufficient awareness among clinicians and underestimation of the magnitude of this disease. […] The purpose of this study was to determine the incidence of CMI and to examine the influence of the etiological cause, location, and severity of a mesenteric artery stenosis on the occurrence of CMI in symptomatic patients with suspected CMI. […] The incidence of all-cause CMI was found to have an incidence of 9.2 per 100,000 inhabitants, which approximates the incidence of Crohn’s disease. […] The current study sheds a different light on this widespread misconception.

• #14

  https://journals.lww.com/ctg/fulltext/2020/08000/the_incidence_of_chronic_mesenteric_ischemia_in.6.aspx

  The observed incidence of all-cause CMI of at least 9.2 per 100,000 inhabitants overrules the notion that CMI is a rare disease. […] The incidence of all-cause CMI is higher than the incidence of ruptured abdominal aortic aneurysms and almost twice as high as the incidence of occlusive acute mesenteric ischemia. […] The incidence of CMI was highest in female patients and increased with age. […] The probability of CMI seems highest in suspected CMI patients with multivessel disease or a 70% atherosclerotic single-vessel superior mesenteric artery stenosis. […] The minimally relevant percentage stenosis to develop CMI seems 70% for single-vessel stenosis, whereas in multivessel disease a 50% stenosis already suffices.

• #15 Acute Mesenteric Ischemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431068/

  AMI is a rare syndrome with a prevalence of 1 out of 1000 hospital admissions. […] For all cases of AMI, arterial embolism accounts for 40% to 50%, arterial thrombosis 25% to 30%, and NOMI represents 20% of cases. […] AMI is typically seen in women, older patients, and patients presenting with numerous severe comorbidities.

• #16 Intestinal ischemia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/intestinal-ischemia/

  Most common type of intestinal ischemia […] Most commonly affects individuals 60 years of age […] 80% of cases are nongangrenous, resolving without surgery […] Isolated right-sided colon ischemia (IRCI): 10-25% of cases […] MAOD is common, while CMI is rare […] CMI most commonly occurs in adults 60 years of age […] 5-year mortality for untreated CMI is close to 100%. […] Symptoms are relieved in 95% of patients following revascularization.

• #17 Intestinal Ischemia: US-CT findings correlations | The Ultrasound Journal | Full Text

  https://theultrasoundjournal.springeropen.com/articles/10.1186/2036-7902-5-S1-S7

  NOMI comprises all forms of mesenteric ischemia without occlusion of the mesenteric arteries and accounts for 20-30% of all cases of acute mesenteric ischemia. […] To make an early diagnosis useful to ensure a correct therapeutic approach, it is very important to define if the vascular impairment involves the superior or the inferior mesenteric vessels and if the etiology is occlusive (arterial, venous) or non occlusive (NOMI), distinguishing between acute arterial mesenteric ischemia (AAMI), acute venous mesenteric ischemia (AVMI), non occlusive mesenteric ischemia (NOMI), ischemia/reperfusion injury (I/R), ischemic colitis (IC).

• #18 Acute Mesenteric Ischemia: Epidemiology, Pathophysiology, Clinical Evaluation, and Management – Clinical Tree

  https://clinicalpub.com/acute-mesenteric-ischemia-epidemiology-pathophysiology-clinical-evaluation-and-management/

  Acute mesenteric ischemia accounts for less than 1 of every 1000 hospital admissions. This disease process affects women three times as frequently as men and is typically seen in elderly patients with multiple comorbidities. […] Clinical risk factors often provide clues to the specific pathophysiology. Patients at risk for mesenteric embolus include those with a history of atrial fibrillation/flutter, recent myocardial infarction, congestive heart failure, or peripheral arterial emboli. […] While historical data noted arterial embolism to be the most common cause of acute mesenteric ischemia, recent studies have suggested that in situ thrombosis of chronic lesions may now account for greater than 50% of cases of acute mesenteric ischemia. […] Mesenteric vasospasm, usually in the distribution of the SMA, is the sine qua non of Nonocclusive Mesenteric Ischemia (NOMI). This form of AMI accounts for approximately 20% of presentations, but carries the highest mortality rates. […] Delays in diagnosis and treatment remain the greatest challenge to reducing morbidity and mortality for all forms of mesenteric ischemia.

• #19 Acute mesenteric ischemia: A review of the main imaging techniques and signs | Radiología (English Edition)

  https://www.elsevier.es/en-revista-radiologia-english-edition–419-articulo-acute-mesenteric-ischemia-a-review-S2173510720300501?newsletter=true

  The epidemiological characteristics and risk factors associated with the different aetiologies of AMI are very important in guiding the suspected diagnosis. Arterial embolism is the most common cause of AMI and accounts for 40-50% of all cases. The main risk factors include atrial fibrillation, recent myocardial infarction, congestive heart failure, cardiomyopathies and embolisms due to aortic lesion or atherosclerosis. […] NOMI is often seen in patients of advanced age, and is responsible for approximately 20-30% of cases of AMI. Unlike the above-mentioned disorders, it is an acute disorder of the mesenteric circulation not caused by organic occlusion of the blood vessels that often persists even after the precipitating event is corrected. In terms of pathogenesis, NOMI is believed to arise from a combination of low cardiac output and vasoconstriction. Underlying diseases and risk factors include shock, dialysis, heart disorders, long-term extracorporeal circulation, postoperative stress, use of certain drug treatments (catecholamines, digitalis drugs and diuretics), arrhythmias, burns, diabetes, pancreatitis, dehydration and hypovolaemia. This condition is characterised by high rates of morbidity and mortality, due to patients’ advanced age and diagnostic delay.

• #20 Bowel Ischemia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/18478

  Bowel ischemia can affect a small or large intestine and can occur by any cause, which leads to intestinal blood flow reduction. This is an uncommon medical condition, but it has a high mortality rate. […] An acute decrease in mesenteric arterial blood flow causes 60% to 70% of patients with mesenteric ischemia. The rest of the causes are related to colonic ischemia and chronic mesenteric ischemia. Mesenteric ischemia (MI) accounts for 0.1% of all hospital admissions, despite this being a rare medical condition. It has high mortality rates ranging from 24% to 94%. The incidence of colonic ischemia is approximately 16 cases per 100,000 person-years, and it is increasing over time. Ischemic colitis is reported for 1 in 2000 hospital admissions. This medical condition is more common in females.

• #21 Ischemic colitis – Wikipedia

  https://en.wikipedia.org/wiki/Ischemic_colitis

  The exact incidence of ischemic colitis is difficult to estimate, as many patients with mild ischemia may not seek medical attention. Ischemic colitis is responsible for about 1 in 2000 hospital admissions and is seen on about 1 in 100 endoscopies. Men and women are affected equally; ischemic colitis is a disease of the elderly, with more than 90% of cases occurring in people over the age of 60.

• #22 Intestinal ischemia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/intestinal-ischemia/

  Most common type of intestinal ischemia […] Most commonly affects individuals 60 years of age […] 80% of cases are nongangrenous, resolving without surgery […] Isolated right-sided colon ischemia (IRCI): 10-25% of cases […] MAOD is common, while CMI is rare […] CMI most commonly occurs in adults 60 years of age […] 5-year mortality for untreated CMI is close to 100%. […] Symptoms are relieved in 95% of patients following revascularization.

• #23 Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-022-00443-x

  The prevalence of AMI has changed in recent decades. The prevalence of acute mesenteric occlusion among patients with an acute abdomen may vary from 17.7% in emergency laparotomy and 31.0% in laparotomy for elderly non-trauma patients. […] The incidence of AMI increases exponentially with age. In patients aged 75 years or older, AMI is a more prevalent cause of acute abdomen than appendicitis. […] The incidence of AMI in an 80-year-old is roughly tenfold that of a 60-year-old patient. […] The management of patients with AMI is summarized in Fig. 1.

• #24 Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-022-00443-x

  The prevalence of AMI has changed in recent decades. The prevalence of acute mesenteric occlusion among patients with an acute abdomen may vary from 17.7% in emergency laparotomy and 31.0% in laparotomy for elderly non-trauma patients. […] The incidence of AMI increases exponentially with age. In patients aged 75 years or older, AMI is a more prevalent cause of acute abdomen than appendicitis. […] The incidence of AMI in an 80-year-old is roughly tenfold that of a 60-year-old patient. […] The management of patients with AMI is summarized in Fig. 1.

• #25

  https://journals.lww.com/ajg/fulltext/2015/01000/acg_clinical_guideline__epidemiology,_risk.8.aspx

  A recently published population-based study yielded an incidence of 16.3 cases/100,000 person-years with a nearly fourfold increase over 34 years. […] CI occurs in adults of all ages and increases with age, especially after age 49 years. […] CI is more common in women than in men, and 5776% of patients in large series have been female. […] Mortality rates in large series range from 4 to 12%, but inclusion criteria, case ascertainment methods, and rates of comorbidity and surgery in these studies differed. […] Recurrent CI increases over time; for example, estimated cumulative recurrence rates at 1, 23, 4, and 56 years were 3%, 5%, 6%, and 10%, respectively, in one study and 3.3% at 2 years and 7.5% at 5 years in another study. […] Therefore, in any large survey, recurrence will be related to the relative proportions of patients with spontaneous, idiopathic disease and those with illnesses likely to foster recurrence.

• #26

  https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-gastrointestinal/mesenteric-ischemia

  Mesenteric ischemia remains a very difficult disease process to identify early. […] The incidence may be rising because of an aging population with significant co-morbidities such as atrial fibrillation, atherosclerosis, congestive heart failure, and hypercoagulability. […] The importance of early consideration and diagnosis of mesenteric ischemia cannot be overemphasized. […] The classic presentation for mesenteric ischemia will be in a patient over the age of 60. […] Women are three times more likely than men to have acute mesenteric ischemia. […] The mortality rate for mesenteric ischemia remains high despite new diagnostic testing. […] The four causes of mesenteric ischemia are mesenteric artery embolism (commonly due to atrial fibrillation), mesenteric artery thrombosis (commonly due to atherosclerosis), mesenteric vein thrombosis (commonly due to hypercoagulability) and non-occlusive mesenteric ischemia (commonly due to low flow states). […] CT angiography has replaced mesenteric angiography as the initial imaging study due to being less invasive, readily available, and having the ability to diagnose other causes for abdominal pain.

• #27 Mesenteric Ischemia

  https://mobile.fpnotebook.com/Surgery/GI/MsntrcIschm.htm

  Uncommon condition (but requires high index suspicion) […] Accounts for 0.1 to 1% of Acute Abdominal Pain admissions […] Mortality is as high as 24-94% […] Rapid diagnosis is critical to survival […] More common in patients over age 60 years old […] More common in women (3 fold increased risk over men).

• #28 Chronic Mesenteric Ischemia: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/183683-overview

  Chronic mesenteric ischemia (CMI) is a rare diagnosis. In 1997, Moawad and Gewertz searched 20 years of literature and found only 330 cases. […] In 2013, Pecoraro et al included 1795 cases in their systematic review of 25 years of literature. […] Because many cases are not reported, the true prevalence could be much higher. Autopsy studies support this possibility, with findings of stenosis in as many as 30% of selected patients with a history of abdominal pain. No differences in frequency have been reported in various regions of the world. […] CMI generally occurs in patients older than 60 years. […] Most studies have found it to be more prevalent in females than in males.

• #29 Mesenteric ischemia: Recognizing an uncommon disorder and distinguishing among its causes | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/91/9/545

  Mesenteric ischemia occurs because of inadequate intestinal blood flow. Its severity depends on the vessels involved and whether collateral blood vessels are available to prevent malperfusion. Mesenteric ischemia is an uncommon cause of abdominal pain, but it is associated with high mortality and often poses a diagnostic challenge to clinicians because its symptoms are nonspecific. Early recognition and treatment are imperative to improve patient outcomes. […] Mesenteric ischemia is classified into acute or chronic subtypes according to the timing of vessel occlusion and onset of symptoms. […] Diagnosis requires a high index of suspicion with focused evaluation. […] Early recognition and intervention are key to preventing morbidity and mortality. […] Mesenteric ischemia remains a diagnostic challenge to many clinicians because it is uncommon and its symptoms are nonspecific. Early recognition and focused evaluation are crucial for timely diagnosis and prevention of catastrophic complications.

• #30 Intestinal ischemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intestinal-ischemia/symptoms-causes/syc-20373946

  Intestinal ischemia (is-KEE-me-uh) refers to a range of conditions that happen when blood flow to the intestines slows or stops. Ischemia can be due to a fully or partly blocked blood vessel, most often an artery. Or low blood pressure may lead to less blood flow. Intestinal ischemia can affect the small intestine, the large intestine or both. […] Intestinal ischemia often is split into groups. Colon ischemia, also called ischemic colitis, affects the large intestine. Other types of ischemia affect the small intestine. These are acute mesenteric ischemia, chronic mesenteric ischemia and ischemia due to mesenteric venous thrombosis. […] Factors that may increase your risk of intestinal ischemia include: Buildup of fatty deposits in your arteries, called atherosclerosis. If you’ve had other conditions caused by atherosclerosis, you have an increased risk of intestinal ischemia. These conditions include less blood flow to the heart, called coronary artery disease; less blood flow to the legs, called peripheral vascular disease; or less blood flow to the arteries that go to the brain, called carotid artery disease. […] Chronic mesenteric ischemia is due to the buildup of fatty deposits on an artery wall, called atherosclerosis. The disease process most often is slow. It’s also called intestinal angina because it’s due to less blood flow to the intestines after eating.

• #31 Chronic Mesenteric Ischemia: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/183683-overview

  Chronic mesenteric ischemia (CMI) is a rare diagnosis. In 1997, Moawad and Gewertz searched 20 years of literature and found only 330 cases. […] In 2013, Pecoraro et al included 1795 cases in their systematic review of 25 years of literature. […] Because many cases are not reported, the true prevalence could be much higher. Autopsy studies support this possibility, with findings of stenosis in as many as 30% of selected patients with a history of abdominal pain. No differences in frequency have been reported in various regions of the world. […] CMI generally occurs in patients older than 60 years. […] Most studies have found it to be more prevalent in females than in males.

• #32 Acute Mesenteric Ischemia: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/189146-overview

  AMI is believed to account for 0.1% of all hospital admissions; this figure may be expected to rise as the population ages. Annual incidence in the general population has been reported to be in the range of 0.63-12.9 per 100,000. […] The exact prevalence of MVT is not known, because many cases are presumed to be limited in symptomatology and to resolve spontaneously. It is believed to account for approximately 10-15% of all cases of mesenteric ischemia and for 0.006% of hospital admissions. Venous thrombosis is found in approximately 0.001% of patients who undergo exploratory laparotomy. […] Risk factors for AMI include atherosclerosis, arrhythmias, hypovolemia, CHF, recent MI, valvular disease, advanced age, and intra-abdominal malignancy. […] Mesenteric artery stenosis is found in 17.5% of independent elderly adults.

• #33 Intestinal ischemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intestinal-ischemia/symptoms-causes/syc-20373946

  Intestinal ischemia (is-KEE-me-uh) refers to a range of conditions that happen when blood flow to the intestines slows or stops. Ischemia can be due to a fully or partly blocked blood vessel, most often an artery. Or low blood pressure may lead to less blood flow. Intestinal ischemia can affect the small intestine, the large intestine or both. […] Intestinal ischemia often is split into groups. Colon ischemia, also called ischemic colitis, affects the large intestine. Other types of ischemia affect the small intestine. These are acute mesenteric ischemia, chronic mesenteric ischemia and ischemia due to mesenteric venous thrombosis. […] Factors that may increase your risk of intestinal ischemia include: Buildup of fatty deposits in your arteries, called atherosclerosis. If you’ve had other conditions caused by atherosclerosis, you have an increased risk of intestinal ischemia. These conditions include less blood flow to the heart, called coronary artery disease; less blood flow to the legs, called peripheral vascular disease; or less blood flow to the arteries that go to the brain, called carotid artery disease. […] Chronic mesenteric ischemia is due to the buildup of fatty deposits on an artery wall, called atherosclerosis. The disease process most often is slow. It’s also called intestinal angina because it’s due to less blood flow to the intestines after eating.

• #34

  https://step2.medbullets.com/gastrointestinal/121785/mesenteric-ischemia

  most commonly affects people 60 years of age […] atrial fibrillation […] heart failure […] chronic kidney failure […] hypercoagulable states […] previous myocardial infarction

• #35 What is bowel ischaemia? – Heart Matters magazine – BHF

  https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/ask-the-experts/bowel-ischaemia

  Ischaemic bowel is a rare circulatory condition which can be linked with other heart and circulatory diseases. It comes in different forms. […] Serious cases are relatively rare, although theres a lack of good evidence about exactly how common it is. The available figures suggest that ischaemic bowel and similar conditions cause 5-6,000 hospital admissions and 3,000 deaths in the UK each year. […] The majority of people affected are over 50, and it is more common in women. […] When the bowel arteries are scanned in patients who have previously had a heart attack or stroke, around one person in eight has some disease in their bowel arteries. […] In patients with peripheral arterial disease (problems with arteries in the feet and legs), about one in four have bowel artery disease. […] However most of these patients dont have any symptoms and the condition is mild. […] We do not know exactly how many of these patients do go on to develop symptoms but evidence suggests it is small, less than 1 in 20.

• #36 Acute Mesenteric Ischemia: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/189146-overview

  AMI is believed to account for 0.1% of all hospital admissions; this figure may be expected to rise as the population ages. Annual incidence in the general population has been reported to be in the range of 0.63-12.9 per 100,000. […] The exact prevalence of MVT is not known, because many cases are presumed to be limited in symptomatology and to resolve spontaneously. It is believed to account for approximately 10-15% of all cases of mesenteric ischemia and for 0.006% of hospital admissions. Venous thrombosis is found in approximately 0.001% of patients who undergo exploratory laparotomy. […] Risk factors for AMI include atherosclerosis, arrhythmias, hypovolemia, CHF, recent MI, valvular disease, advanced age, and intra-abdominal malignancy. […] Mesenteric artery stenosis is found in 17.5% of independent elderly adults.

• #37 Acute Mesenteric Ischemia: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/189146-overview

  Approximately two thirds of patients are women. […] Research indicates that inflammatory bowel disease (IBD) is another risk factor for mesenteric artery thrombosis. […] In a review comparing 17,487 patients who had either Crohn disease or ulcerative colitis with 69,948 control subjects, the investigators detected a significantly higher risk of AMI in the patients with IBD. […] Outside the United States, reported rates of AMI are probably lower in countries with limited diagnostic capability or whose populations have a shorter life expectancy because AMI is primarily a disease of older individuals.

• #38 Bowel Ischaemia | Doctor

  https://patient.info/doctor/bowel-ischaemia

  How common is acute mesenteric ischaemia? (epidemiology) […] This is chiefly a disease of people aged over 50, although younger people with risk factors for mesenteric venous thrombosis (MVT) – eg, atrial fibrillation (AF) – can be affected. The overall incidence is low – around 0.09-0.2% of all hospital admissions – but is a common indication for emergency intestinal resection.1 […] How common is chronic mesenteric ischaemia? (Epidemiology) […] Chronic mesenteric ischaemia has a very low incidence, accounting for less than 1 in 1,000 hospital admissions for abdominal pain.3 […] How common is ischaemic colitis? (Epidemiology) […] The incidence of ischaemic colitis rose from 6.1 cases/100000 person-years in 1976-80 to 22.9/100000 in 2005-09.6 Many mild cases may go unreported. […] Because the most common cause is atheroma of the mesenteric vessels it is mainly a disease of the elderly and is rare before the age of 60. […] The average age for diagnosis is 70. The incidence is likely to increase with the increasing age of the population. The condition is, however, by no means unknown in younger age groups, due to non-cardiovascular causes such as cocaine abuse.

• #39 Intestinal Ischemia – Internal Medicine Residency Handbook

  https://vim-book.org/gastroenterology/gastroenterology-intestinal-ischemia/

  Sudden onset or absence of blood flow to the small intestines. […] High-grade mesenteric vascular stenoses in at least two major vessels (celiac, SMA, or IMA) must be established. […] Most often nonocclusive (95% of cases) and affects older adults. […] Risk factors: ACS, hemodialysis, shock, aortoiliac instrumentation, cardiopulmonary bypass, extreme exercise (marathon running). […] CTA abdomen/pelvis is preferred (90% sensitivity and specificity). […] Goal is to prevent future bowel infarction.

• #40 Acute mesenteric ischemia: A review of the main imaging techniques and signs | Radiología (English Edition)

  https://www.elsevier.es/en-revista-radiologia-english-edition–419-articulo-acute-mesenteric-ischemia-a-review-S2173510720300501?newsletter=true

  The epidemiological characteristics and risk factors associated with the different aetiologies of AMI are very important in guiding the suspected diagnosis. Arterial embolism is the most common cause of AMI and accounts for 40-50% of all cases. The main risk factors include atrial fibrillation, recent myocardial infarction, congestive heart failure, cardiomyopathies and embolisms due to aortic lesion or atherosclerosis. […] NOMI is often seen in patients of advanced age, and is responsible for approximately 20-30% of cases of AMI. Unlike the above-mentioned disorders, it is an acute disorder of the mesenteric circulation not caused by organic occlusion of the blood vessels that often persists even after the precipitating event is corrected. In terms of pathogenesis, NOMI is believed to arise from a combination of low cardiac output and vasoconstriction. Underlying diseases and risk factors include shock, dialysis, heart disorders, long-term extracorporeal circulation, postoperative stress, use of certain drug treatments (catecholamines, digitalis drugs and diuretics), arrhythmias, burns, diabetes, pancreatitis, dehydration and hypovolaemia. This condition is characterised by high rates of morbidity and mortality, due to patients’ advanced age and diagnostic delay.

• #41 Intestinal Ischemia – Internal Medicine Residency Handbook

  https://vim-book.org/gastroenterology/gastroenterology-intestinal-ischemia/

  Sudden onset or absence of blood flow to the small intestines. […] High-grade mesenteric vascular stenoses in at least two major vessels (celiac, SMA, or IMA) must be established. […] Most often nonocclusive (95% of cases) and affects older adults. […] Risk factors: ACS, hemodialysis, shock, aortoiliac instrumentation, cardiopulmonary bypass, extreme exercise (marathon running). […] CTA abdomen/pelvis is preferred (90% sensitivity and specificity). […] Goal is to prevent future bowel infarction.

• #42 Intestinal ischemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intestinal-ischemia/symptoms-causes/syc-20373946

  Intestinal ischemia (is-KEE-me-uh) refers to a range of conditions that happen when blood flow to the intestines slows or stops. Ischemia can be due to a fully or partly blocked blood vessel, most often an artery. Or low blood pressure may lead to less blood flow. Intestinal ischemia can affect the small intestine, the large intestine or both. […] Intestinal ischemia often is split into groups. Colon ischemia, also called ischemic colitis, affects the large intestine. Other types of ischemia affect the small intestine. These are acute mesenteric ischemia, chronic mesenteric ischemia and ischemia due to mesenteric venous thrombosis. […] Factors that may increase your risk of intestinal ischemia include: Buildup of fatty deposits in your arteries, called atherosclerosis. If you’ve had other conditions caused by atherosclerosis, you have an increased risk of intestinal ischemia. These conditions include less blood flow to the heart, called coronary artery disease; less blood flow to the legs, called peripheral vascular disease; or less blood flow to the arteries that go to the brain, called carotid artery disease. […] Chronic mesenteric ischemia is due to the buildup of fatty deposits on an artery wall, called atherosclerosis. The disease process most often is slow. It’s also called intestinal angina because it’s due to less blood flow to the intestines after eating.

• #43 Intestinal Ischemia | AMBOSS Rotation Prep

  https://resident360.amboss.com/adult-medicine/gastroenterology/intestinal-ischemia/intestinal-ischemia.html

  Intestinal ischemia can be broadly categorized as either mesenteric (small-bowel) ischemia or colonic ischemia and can present as acute or chronic disease. […] Although intestinal ischemia is largely considered a rare cause of abdominal pain, delayed diagnosis can be associated with significant morbidity and mortality. […] Mesenteric ischemia can be difficult to diagnose because of the rare incidence and nonspecific symptoms. Therefore, diagnosis requires a high index of suspicion. […] Evaluation and diagnosis of colonic ischemia is similar to that of mesenteric ischemia except that large-vessel thrombus or embolus are seldom the cause of colonic ischemia. […] The American College of Gastroenterology (ACG) guidelines for diagnosing and managing colonic ischemia can be found here.

• #44 Intestinal Ischemia | Concise Medical Knowledge

  https://www.lecturio.com/concepts/intestinal-ischemia/

  For all types, intestinal ischemia primarily affects adults 60 years of age. […] Ischemic colitis: most common type of intestinal ischemia (approximately 60%-70%). […] Acute mesenteric ischemia: In addition to older adults, may also occur in younger people with atrial fibrillation and hypercoagulable states. […] Mortality rates: Occlusive mesenteric infarction has a mortality rate (approximately 60%). […] Chronic mesenteric ischemia: incidence.

• #45 Ischemic colitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ischaemic-colitis?lang=us

  Ischemic bowel is typically a disease of the elderly (age 60 years) where atherosclerotic disease or low flow states are usually the cause. It is rare in younger individuals, where it is more likely to be related to vasculitis or hypercoagulable states. […] Prognosis is variable: resolution without ongoing complications ~50%, persistent colitis ~20%, ischemic stricture ~10%, gangrene or perforation ~20%. […] Occlusive mesenteric infarction (embolus or thrombosis) has a high mortality rate (~90%) compared to non-occlusive ischemia (~10%).

• #46

  https://journals.lww.com/ajg/fulltext/2015/01000/acg_clinical_guideline__epidemiology,_risk.8.aspx

  A recently published population-based study yielded an incidence of 16.3 cases/100,000 person-years with a nearly fourfold increase over 34 years. […] CI occurs in adults of all ages and increases with age, especially after age 49 years. […] CI is more common in women than in men, and 5776% of patients in large series have been female. […] Mortality rates in large series range from 4 to 12%, but inclusion criteria, case ascertainment methods, and rates of comorbidity and surgery in these studies differed. […] Recurrent CI increases over time; for example, estimated cumulative recurrence rates at 1, 23, 4, and 56 years were 3%, 5%, 6%, and 10%, respectively, in one study and 3.3% at 2 years and 7.5% at 5 years in another study. […] Therefore, in any large survey, recurrence will be related to the relative proportions of patients with spontaneous, idiopathic disease and those with illnesses likely to foster recurrence.

• #47 Bowel Ischaemia | Doctor

  https://patient.info/doctor/bowel-ischaemia

  How common is acute mesenteric ischaemia? (epidemiology) […] This is chiefly a disease of people aged over 50, although younger people with risk factors for mesenteric venous thrombosis (MVT) – eg, atrial fibrillation (AF) – can be affected. The overall incidence is low – around 0.09-0.2% of all hospital admissions – but is a common indication for emergency intestinal resection.1 […] How common is chronic mesenteric ischaemia? (Epidemiology) […] Chronic mesenteric ischaemia has a very low incidence, accounting for less than 1 in 1,000 hospital admissions for abdominal pain.3 […] How common is ischaemic colitis? (Epidemiology) […] The incidence of ischaemic colitis rose from 6.1 cases/100000 person-years in 1976-80 to 22.9/100000 in 2005-09.6 Many mild cases may go unreported. […] Because the most common cause is atheroma of the mesenteric vessels it is mainly a disease of the elderly and is rare before the age of 60. […] The average age for diagnosis is 70. The incidence is likely to increase with the increasing age of the population. The condition is, however, by no means unknown in younger age groups, due to non-cardiovascular causes such as cocaine abuse.

• #48

  https://journals.lww.com/ajg/fulltext/2015/01000/acg_clinical_guideline__epidemiology,_risk.8.aspx

  The absence of a unique diagnosis code for acute large bowel ischemia in the ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) challenges case finding for research. […] CI, the term we prefer to ischemic colitis because some patients do not have a documented inflammatory phase of disease, is the etiology in 924% of all patients hospitalized for acute lower gastrointestinal bleeding, ranking CI first, second, or third behind colorectal malignancy in large epidemiological surveys. […] A national insurance claims-based survey of patients hospitalized with CI revealed an annual incidence rate of 17.7 cases/100,000. […] In the population-based, record-review study of patients hospitalized in the Kaiser San Diego Medical Care Program, the estimated annual incidence was 15.6 patients/100,000 (women, 22.6; men, 8.0).

• #49 Intestinal ischemia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/intestinal-ischemia/

  Most common type of intestinal ischemia […] Most commonly affects individuals 60 years of age […] 80% of cases are nongangrenous, resolving without surgery […] Isolated right-sided colon ischemia (IRCI): 10-25% of cases […] MAOD is common, while CMI is rare […] CMI most commonly occurs in adults 60 years of age […] 5-year mortality for untreated CMI is close to 100%. […] Symptoms are relieved in 95% of patients following revascularization.

• #50 Intestinal ischemia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/intestinal-ischemia/

  Most common type of intestinal ischemia […] Most commonly affects individuals 60 years of age […] 80% of cases are nongangrenous, resolving without surgery […] Isolated right-sided colon ischemia (IRCI): 10-25% of cases […] MAOD is common, while CMI is rare […] CMI most commonly occurs in adults 60 years of age […] 5-year mortality for untreated CMI is close to 100%. […] Symptoms are relieved in 95% of patients following revascularization.

• #51 Ischemic colitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ischaemic-colitis?lang=us

  Ischemic bowel is typically a disease of the elderly (age 60 years) where atherosclerotic disease or low flow states are usually the cause. It is rare in younger individuals, where it is more likely to be related to vasculitis or hypercoagulable states. […] Prognosis is variable: resolution without ongoing complications ~50%, persistent colitis ~20%, ischemic stricture ~10%, gangrene or perforation ~20%. […] Occlusive mesenteric infarction (embolus or thrombosis) has a high mortality rate (~90%) compared to non-occlusive ischemia (~10%).

• #52

  https://journals.lww.com/ajg/fulltext/2015/01000/acg_clinical_guideline__epidemiology,_risk.8.aspx

  A recently published population-based study yielded an incidence of 16.3 cases/100,000 person-years with a nearly fourfold increase over 34 years. […] CI occurs in adults of all ages and increases with age, especially after age 49 years. […] CI is more common in women than in men, and 5776% of patients in large series have been female. […] Mortality rates in large series range from 4 to 12%, but inclusion criteria, case ascertainment methods, and rates of comorbidity and surgery in these studies differed. […] Recurrent CI increases over time; for example, estimated cumulative recurrence rates at 1, 23, 4, and 56 years were 3%, 5%, 6%, and 10%, respectively, in one study and 3.3% at 2 years and 7.5% at 5 years in another study. […] Therefore, in any large survey, recurrence will be related to the relative proportions of patients with spontaneous, idiopathic disease and those with illnesses likely to foster recurrence.

• #53

  https://journals.lww.com/ajg/fulltext/2015/01000/acg_clinical_guideline__epidemiology,_risk.8.aspx

  A recently published population-based study yielded an incidence of 16.3 cases/100,000 person-years with a nearly fourfold increase over 34 years. […] CI occurs in adults of all ages and increases with age, especially after age 49 years. […] CI is more common in women than in men, and 5776% of patients in large series have been female. […] Mortality rates in large series range from 4 to 12%, but inclusion criteria, case ascertainment methods, and rates of comorbidity and surgery in these studies differed. […] Recurrent CI increases over time; for example, estimated cumulative recurrence rates at 1, 23, 4, and 56 years were 3%, 5%, 6%, and 10%, respectively, in one study and 3.3% at 2 years and 7.5% at 5 years in another study. […] Therefore, in any large survey, recurrence will be related to the relative proportions of patients with spontaneous, idiopathic disease and those with illnesses likely to foster recurrence.

• #54 Intestinal Ischemia | SpringerLink

  https://link.springer.com/10.1007/978-3-030-30192-7_65

  Intestinal ischemia (II), acute and chronic, are often related to older age and risks for thromboembolic disorders. […] The two major types of II are ischemic colitis (IC), more frequent and with an overall better prognosis, and mesenteric ischemia (MI), less recurrent, with a much worse prognosis. […] Acute mesenteric ischemia (AMI) is a vascular emergency, as a result of small intestinal hypoperfusion and infarction that arises from interruption of blood flow within the superior mesenteric artery or vein and has a catastrophic clinical course. […] The high mortality rate is related to the nonspecific symptoms, lack of diagnostic serological markers, difficulty, and associated delay in diagnosis, all causing rapid tissue deterioration. […] A population-based study of incidence, risk factors, clinical spectrum, and outcomes of ischemic colitis.

• #55 Acute Mesenteric Ischemia: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/189146-overview

  AMI is believed to account for 0.1% of all hospital admissions; this figure may be expected to rise as the population ages. Annual incidence in the general population has been reported to be in the range of 0.63-12.9 per 100,000. […] The exact prevalence of MVT is not known, because many cases are presumed to be limited in symptomatology and to resolve spontaneously. It is believed to account for approximately 10-15% of all cases of mesenteric ischemia and for 0.006% of hospital admissions. Venous thrombosis is found in approximately 0.001% of patients who undergo exploratory laparotomy. […] Risk factors for AMI include atherosclerosis, arrhythmias, hypovolemia, CHF, recent MI, valvular disease, advanced age, and intra-abdominal malignancy. […] Mesenteric artery stenosis is found in 17.5% of independent elderly adults.

• #56

  https://link.springer.com/article/10.1007/s00268-022-06805-5

  There is a lack of population-based studies on acute mesenteric ischemia (AMI). […] We have therefore performed a nationwide epidemiological study in Estonia, addressing incidence, demographics, interventions and mortality of AMI. […] Overall, 577 cases of AMI were identifiedan annual incidence of 8.7 per 100,000. […] The population-based annual incidence of AMI in Estonia was 8.7 per 100,000 during the study period. […] The overall hospital mortality and 1 year mortality were 64% and 74%, respectively. […] In the 53% of patients who received active treatment hospital mortality was 32% and 1 year all-cause mortality was 51%.

• #57

  https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-gastrointestinal/mesenteric-ischemia

  Mesenteric ischemia remains a very difficult disease process to identify early. […] The incidence may be rising because of an aging population with significant co-morbidities such as atrial fibrillation, atherosclerosis, congestive heart failure, and hypercoagulability. […] The importance of early consideration and diagnosis of mesenteric ischemia cannot be overemphasized. […] The classic presentation for mesenteric ischemia will be in a patient over the age of 60. […] Women are three times more likely than men to have acute mesenteric ischemia. […] The mortality rate for mesenteric ischemia remains high despite new diagnostic testing. […] The four causes of mesenteric ischemia are mesenteric artery embolism (commonly due to atrial fibrillation), mesenteric artery thrombosis (commonly due to atherosclerosis), mesenteric vein thrombosis (commonly due to hypercoagulability) and non-occlusive mesenteric ischemia (commonly due to low flow states). […] CT angiography has replaced mesenteric angiography as the initial imaging study due to being less invasive, readily available, and having the ability to diagnose other causes for abdominal pain.

• #58 Acute Mesenteric Ischemia: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/189146-overview

  Approximately two thirds of patients are women. […] Research indicates that inflammatory bowel disease (IBD) is another risk factor for mesenteric artery thrombosis. […] In a review comparing 17,487 patients who had either Crohn disease or ulcerative colitis with 69,948 control subjects, the investigators detected a significantly higher risk of AMI in the patients with IBD. […] Outside the United States, reported rates of AMI are probably lower in countries with limited diagnostic capability or whose populations have a shorter life expectancy because AMI is primarily a disease of older individuals.

• #59 Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-017-0150-5

  Severe abdominal pain out of proportion to physical examination findings should be assumed to be AMI until disproven. (Recommendation 1B) […] The overall incidence is low (0.09 to 0.2% of all acute admissions to emergency departments), representing an uncommon cause of abdominal pain. […] Prompt diagnostic and intervention are essential to reduce the high mortality rates (50 to 80%). […] There are currently no level 1 evidence to guide the evaluation and treatment of suspected AMI, and the published literature contains primarily institutional reviews, case series and personal recommendations with no clearly defined treatment guidelines. […] Non-occlusive mesenteric ischemia (NOMI) should be suspected in critically ill patients with abdominal pain or distension requiring vasopressor support and evidence of multi-organ dysfunction. (Recommendation 1B)

• #60

  https://link.springer.com/article/10.1007/s00268-022-06805-5

  There is a lack of population-based studies on acute mesenteric ischemia (AMI). […] We have therefore performed a nationwide epidemiological study in Estonia, addressing incidence, demographics, interventions and mortality of AMI. […] Overall, 577 cases of AMI were identifiedan annual incidence of 8.7 per 100,000. […] The population-based annual incidence of AMI in Estonia was 8.7 per 100,000 during the study period. […] The overall hospital mortality and 1 year mortality were 64% and 74%, respectively. […] In the 53% of patients who received active treatment hospital mortality was 32% and 1 year all-cause mortality was 51%.

• #61 Mesenteric Ischemia: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23246-mesenteric-ischemia

  Mesenteric ischemia is more common as people age. It usually happens along with heart and circulation conditions, especially ones that can cause blood clots. […] Mesenteric ischemia is a rare issue. The estimated number of cases is 1 to 2 for every 1,000 cases where someone needs hospitalization. […] Unfortunately, mesenteric ischemia in any form is a difficult condition to diagnose. Waiting for a diagnosis can delay treatment, and when treatment doesn’t happen quickly, acute mesenteric ischemia is often deadly. The death rate for the acute version of this condition is between 50% and 80%, especially when there are delays in treatment. When treatment happens in under 12 hours from when the blockage started, the death rate can be as low as 14%. Chronic mesenteric ischemia can also have long-term negative effects, either because of the risk of follow-up blood flow problems or nutrition difficulties.

• #62 Acute Mesenteric Ischemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431068/

  AMI is a rare syndrome with a prevalence of 1 out of 1000 hospital admissions. […] For all cases of AMI, arterial embolism accounts for 40% to 50%, arterial thrombosis 25% to 30%, and NOMI represents 20% of cases. […] AMI is typically seen in women, older patients, and patients presenting with numerous severe comorbidities.

• #63 Ischemic colitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ischaemic-colitis?lang=us

  Ischemic bowel is typically a disease of the elderly (age 60 years) where atherosclerotic disease or low flow states are usually the cause. It is rare in younger individuals, where it is more likely to be related to vasculitis or hypercoagulable states. […] Prognosis is variable: resolution without ongoing complications ~50%, persistent colitis ~20%, ischemic stricture ~10%, gangrene or perforation ~20%. […] Occlusive mesenteric infarction (embolus or thrombosis) has a high mortality rate (~90%) compared to non-occlusive ischemia (~10%).

• #64 Chronic mesenteric ischemia – UpToDate

  https://www.uptodate.com/contents/chronic-mesenteric-ischemia

  Chronic mesenteric ischemia, also called intestinal angina, refers to episodic or continuous hypoperfusion of the small intestine that typically occurs in patients with multivessel mesenteric artery stenosis or occlusion. […] The majority of cases of chronic mesenteric ischemia are caused by atherosclerotic narrowing of the origins of the celiac or superior mesenteric arteries. […] While atherosclerosis of the mesenteric vessels is common, clinical manifestations as a consequence of mesenteric arterial disease are rare. […] Up to 18 percent of individuals over 65 years of age in the general population have significant stenosis of the celiac or superior mesenteric artery without any known prior symptoms. […] The occurrence of disease was strongly associated with aging and correlated with atherosclerotic disease of cerebral arteries at the skull base.

• #65 Bowel Ischaemia | Doctor

  https://patient.info/doctor/bowel-ischaemia

  How common is acute mesenteric ischaemia? (epidemiology) […] This is chiefly a disease of people aged over 50, although younger people with risk factors for mesenteric venous thrombosis (MVT) – eg, atrial fibrillation (AF) – can be affected. The overall incidence is low – around 0.09-0.2% of all hospital admissions – but is a common indication for emergency intestinal resection.1 […] How common is chronic mesenteric ischaemia? (Epidemiology) […] Chronic mesenteric ischaemia has a very low incidence, accounting for less than 1 in 1,000 hospital admissions for abdominal pain.3 […] How common is ischaemic colitis? (Epidemiology) […] The incidence of ischaemic colitis rose from 6.1 cases/100000 person-years in 1976-80 to 22.9/100000 in 2005-09.6 Many mild cases may go unreported. […] Because the most common cause is atheroma of the mesenteric vessels it is mainly a disease of the elderly and is rare before the age of 60. […] The average age for diagnosis is 70. The incidence is likely to increase with the increasing age of the population. The condition is, however, by no means unknown in younger age groups, due to non-cardiovascular causes such as cocaine abuse.

• #66

  https://journals.lww.com/ctg/fulltext/2020/08000/the_incidence_of_chronic_mesenteric_ischemia_in.6.aspx

  The observed incidence of all-cause CMI of at least 9.2 per 100,000 inhabitants overrules the notion that CMI is a rare disease. […] The incidence of all-cause CMI is higher than the incidence of ruptured abdominal aortic aneurysms and almost twice as high as the incidence of occlusive acute mesenteric ischemia. […] The incidence of CMI was highest in female patients and increased with age. […] The probability of CMI seems highest in suspected CMI patients with multivessel disease or a 70% atherosclerotic single-vessel superior mesenteric artery stenosis. […] The minimally relevant percentage stenosis to develop CMI seems 70% for single-vessel stenosis, whereas in multivessel disease a 50% stenosis already suffices.

• #67 Chronic Mesenteric Ischemia: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/183683-overview

  Chronic mesenteric ischemia (CMI) is a rare diagnosis. In 1997, Moawad and Gewertz searched 20 years of literature and found only 330 cases. […] In 2013, Pecoraro et al included 1795 cases in their systematic review of 25 years of literature. […] Because many cases are not reported, the true prevalence could be much higher. Autopsy studies support this possibility, with findings of stenosis in as many as 30% of selected patients with a history of abdominal pain. No differences in frequency have been reported in various regions of the world. […] CMI generally occurs in patients older than 60 years. […] Most studies have found it to be more prevalent in females than in males.

• #68 Chronic Mesenteric Ischemia: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/183683-overview

  Chronic mesenteric ischemia (CMI) is a rare diagnosis. In 1997, Moawad and Gewertz searched 20 years of literature and found only 330 cases. […] In 2013, Pecoraro et al included 1795 cases in their systematic review of 25 years of literature. […] Because many cases are not reported, the true prevalence could be much higher. Autopsy studies support this possibility, with findings of stenosis in as many as 30% of selected patients with a history of abdominal pain. No differences in frequency have been reported in various regions of the world. […] CMI generally occurs in patients older than 60 years. […] Most studies have found it to be more prevalent in females than in males.

• #69 Intestinal ischemia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/intestinal-ischemia/

  Most common type of intestinal ischemia […] Most commonly affects individuals 60 years of age […] 80% of cases are nongangrenous, resolving without surgery […] Isolated right-sided colon ischemia (IRCI): 10-25% of cases […] MAOD is common, while CMI is rare […] CMI most commonly occurs in adults 60 years of age […] 5-year mortality for untreated CMI is close to 100%. […] Symptoms are relieved in 95% of patients following revascularization.

• #70 Chronic mesenteric ischemia – UpToDate

  https://www.uptodate.com/contents/chronic-mesenteric-ischemia

  Chronic mesenteric ischemia, also called intestinal angina, refers to episodic or continuous hypoperfusion of the small intestine that typically occurs in patients with multivessel mesenteric artery stenosis or occlusion. […] The majority of cases of chronic mesenteric ischemia are caused by atherosclerotic narrowing of the origins of the celiac or superior mesenteric arteries. […] While atherosclerosis of the mesenteric vessels is common, clinical manifestations as a consequence of mesenteric arterial disease are rare. […] Up to 18 percent of individuals over 65 years of age in the general population have significant stenosis of the celiac or superior mesenteric artery without any known prior symptoms. […] The occurrence of disease was strongly associated with aging and correlated with atherosclerotic disease of cerebral arteries at the skull base.

• #71 Intestinal ischemia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/intestinal-ischemia/

  Most common type of intestinal ischemia […] Most commonly affects individuals 60 years of age […] 80% of cases are nongangrenous, resolving without surgery […] Isolated right-sided colon ischemia (IRCI): 10-25% of cases […] MAOD is common, while CMI is rare […] CMI most commonly occurs in adults 60 years of age […] 5-year mortality for untreated CMI is close to 100%. […] Symptoms are relieved in 95% of patients following revascularization.

• #72

  https://journals.lww.com/ajg/fulltext/2015/01000/acg_clinical_guideline__epidemiology,_risk.8.aspx

  The absence of a unique diagnosis code for acute large bowel ischemia in the ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) challenges case finding for research. […] CI, the term we prefer to ischemic colitis because some patients do not have a documented inflammatory phase of disease, is the etiology in 924% of all patients hospitalized for acute lower gastrointestinal bleeding, ranking CI first, second, or third behind colorectal malignancy in large epidemiological surveys. […] A national insurance claims-based survey of patients hospitalized with CI revealed an annual incidence rate of 17.7 cases/100,000. […] In the population-based, record-review study of patients hospitalized in the Kaiser San Diego Medical Care Program, the estimated annual incidence was 15.6 patients/100,000 (women, 22.6; men, 8.0).

• #73

  https://journals.lww.com/ajg/fulltext/2015/01000/acg_clinical_guideline__epidemiology,_risk.8.aspx

  The absence of a unique diagnosis code for acute large bowel ischemia in the ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) challenges case finding for research. […] CI, the term we prefer to ischemic colitis because some patients do not have a documented inflammatory phase of disease, is the etiology in 924% of all patients hospitalized for acute lower gastrointestinal bleeding, ranking CI first, second, or third behind colorectal malignancy in large epidemiological surveys. […] A national insurance claims-based survey of patients hospitalized with CI revealed an annual incidence rate of 17.7 cases/100,000. […] In the population-based, record-review study of patients hospitalized in the Kaiser San Diego Medical Care Program, the estimated annual incidence was 15.6 patients/100,000 (women, 22.6; men, 8.0).

• #74 Ischemic colitis – Wikipedia

  https://en.wikipedia.org/wiki/Ischemic_colitis

  The exact incidence of ischemic colitis is difficult to estimate, as many patients with mild ischemia may not seek medical attention. Ischemic colitis is responsible for about 1 in 2000 hospital admissions and is seen on about 1 in 100 endoscopies. Men and women are affected equally; ischemic colitis is a disease of the elderly, with more than 90% of cases occurring in people over the age of 60.

• #75 Bowel Ischaemia | Doctor

  https://patient.info/doctor/bowel-ischaemia

  How common is acute mesenteric ischaemia? (epidemiology) […] This is chiefly a disease of people aged over 50, although younger people with risk factors for mesenteric venous thrombosis (MVT) – eg, atrial fibrillation (AF) – can be affected. The overall incidence is low – around 0.09-0.2% of all hospital admissions – but is a common indication for emergency intestinal resection.1 […] How common is chronic mesenteric ischaemia? (Epidemiology) […] Chronic mesenteric ischaemia has a very low incidence, accounting for less than 1 in 1,000 hospital admissions for abdominal pain.3 […] How common is ischaemic colitis? (Epidemiology) […] The incidence of ischaemic colitis rose from 6.1 cases/100000 person-years in 1976-80 to 22.9/100000 in 2005-09.6 Many mild cases may go unreported. […] Because the most common cause is atheroma of the mesenteric vessels it is mainly a disease of the elderly and is rare before the age of 60. […] The average age for diagnosis is 70. The incidence is likely to increase with the increasing age of the population. The condition is, however, by no means unknown in younger age groups, due to non-cardiovascular causes such as cocaine abuse.

• #76 Mesenteric ischemia: Recognizing an uncommon disorder and distinguishing among its causes | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/91/9/545

  Mesenteric ischemia occurs because of inadequate intestinal blood flow. Its severity depends on the vessels involved and whether collateral blood vessels are available to prevent malperfusion. Mesenteric ischemia is an uncommon cause of abdominal pain, but it is associated with high mortality and often poses a diagnostic challenge to clinicians because its symptoms are nonspecific. Early recognition and treatment are imperative to improve patient outcomes. […] Mesenteric ischemia is classified into acute or chronic subtypes according to the timing of vessel occlusion and onset of symptoms. […] Diagnosis requires a high index of suspicion with focused evaluation. […] Early recognition and intervention are key to preventing morbidity and mortality. […] Mesenteric ischemia remains a diagnostic challenge to many clinicians because it is uncommon and its symptoms are nonspecific. Early recognition and focused evaluation are crucial for timely diagnosis and prevention of catastrophic complications.

• #77 Intestinal Ischemia | AMBOSS Rotation Prep

  https://resident360.amboss.com/adult-medicine/gastroenterology/intestinal-ischemia/intestinal-ischemia.html

  Intestinal ischemia can be broadly categorized as either mesenteric (small-bowel) ischemia or colonic ischemia and can present as acute or chronic disease. […] Although intestinal ischemia is largely considered a rare cause of abdominal pain, delayed diagnosis can be associated with significant morbidity and mortality. […] Mesenteric ischemia can be difficult to diagnose because of the rare incidence and nonspecific symptoms. Therefore, diagnosis requires a high index of suspicion. […] Evaluation and diagnosis of colonic ischemia is similar to that of mesenteric ischemia except that large-vessel thrombus or embolus are seldom the cause of colonic ischemia. […] The American College of Gastroenterology (ACG) guidelines for diagnosing and managing colonic ischemia can be found here.

• #78 Biochemical markers of acute intestinal ischemia: possibilities and limitations

  https://atm.amegroups.org/article/view/20595/html

  In a meta-analysis evaluating the performance of several biomarkers for intestinal ischemia, Evennett et al. calculated a 0.80 (95% CI: 0.66-0.91) sensitivity and a very modest 0.50 (95% CI: 0.31-0.69) specificity of white blood cell count for diagnosing intestinal ischemia. […] Although acute intestinal ischemia remains a relative rare condition, a timely and accurate diagnosis is needed to prevent the development of serious complications, up to death. […] A vast array of laboratory biomarkers has been evaluated in the diagnosis of acute intestinal ischemia, but an ideal biomarker (i.e., rapid, stable, highly specific and sensitive, inexpensive and easy to be measured) is still seemingly missing.

• #79 Biochemical markers of acute intestinal ischemia: possibilities and limitations

  https://atm.amegroups.org/article/view/20595/html

  In a meta-analysis evaluating the performance of several biomarkers for intestinal ischemia, Evennett et al. calculated a 0.80 (95% CI: 0.66-0.91) sensitivity and a very modest 0.50 (95% CI: 0.31-0.69) specificity of white blood cell count for diagnosing intestinal ischemia. […] Although acute intestinal ischemia remains a relative rare condition, a timely and accurate diagnosis is needed to prevent the development of serious complications, up to death. […] A vast array of laboratory biomarkers has been evaluated in the diagnosis of acute intestinal ischemia, but an ideal biomarker (i.e., rapid, stable, highly specific and sensitive, inexpensive and easy to be measured) is still seemingly missing.

• #80 Epidemiology, Risk Factors, Patterns of Presentation, Diagnosis, and Management of Colon Ischemia (CI)

  https://www.mdcalc.com/guidelines/10374/acg/epidemiology-risk-factors-patterns-presentation-diagnosis-management-colon-ischemia-ci

  The diagnosis of CI is usually established in the presence of symptoms including sudden cramping, mild, abdominal pain; an urgent desire to defecate; and passage within 24 h of bright red or maroon blood or bloody diarrhea. […] A diagnosis of non-isolated right colon ischemia (non-IRCI) should be considered when patients present with hematochezia. […] CT with intravenous and oral contrast should be the first imaging modality of choice for patients with suspected CI to assess the distribution and phase of colitis. […] The diagnosis of CI can be suggested based on CT findings (e.g., bowel wall thickening, edema, thumbprinting). […] Multiphasic CTA should be performed on any patient with suspected IRCI or in any patient in whom the possibility of AMI cannot be excluded. […] CT or MRI findings of colonic pneumatosis and porto-mesenteric venous gas can be used to predict the presence of transmural colonic infarction.

• #81 Epidemiology, Risk Factors, Patterns of Presentation, Diagnosis, and Management of Colon Ischemia (CI)

  https://www.mdcalc.com/guidelines/10374/acg/epidemiology-risk-factors-patterns-presentation-diagnosis-management-colon-ischemia-ci

  The diagnosis of CI is usually established in the presence of symptoms including sudden cramping, mild, abdominal pain; an urgent desire to defecate; and passage within 24 h of bright red or maroon blood or bloody diarrhea. […] A diagnosis of non-isolated right colon ischemia (non-IRCI) should be considered when patients present with hematochezia. […] CT with intravenous and oral contrast should be the first imaging modality of choice for patients with suspected CI to assess the distribution and phase of colitis. […] The diagnosis of CI can be suggested based on CT findings (e.g., bowel wall thickening, edema, thumbprinting). […] Multiphasic CTA should be performed on any patient with suspected IRCI or in any patient in whom the possibility of AMI cannot be excluded. […] CT or MRI findings of colonic pneumatosis and porto-mesenteric venous gas can be used to predict the presence of transmural colonic infarction.

• #82

  https://link.springer.com/article/10.1007/s00268-022-06805-5

  There is a lack of population-based studies on acute mesenteric ischemia (AMI). […] We have therefore performed a nationwide epidemiological study in Estonia, addressing incidence, demographics, interventions and mortality of AMI. […] Overall, 577 cases of AMI were identifiedan annual incidence of 8.7 per 100,000. […] The population-based annual incidence of AMI in Estonia was 8.7 per 100,000 during the study period. […] The overall hospital mortality and 1 year mortality were 64% and 74%, respectively. […] In the 53% of patients who received active treatment hospital mortality was 32% and 1 year all-cause mortality was 51%.

• #83

  https://journals.lww.com/ajg/fulltext/2015/01000/acg_clinical_guideline__epidemiology,_risk.8.aspx

  The absence of a unique diagnosis code for acute large bowel ischemia in the ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) challenges case finding for research. […] CI, the term we prefer to ischemic colitis because some patients do not have a documented inflammatory phase of disease, is the etiology in 924% of all patients hospitalized for acute lower gastrointestinal bleeding, ranking CI first, second, or third behind colorectal malignancy in large epidemiological surveys. […] A national insurance claims-based survey of patients hospitalized with CI revealed an annual incidence rate of 17.7 cases/100,000. […] In the population-based, record-review study of patients hospitalized in the Kaiser San Diego Medical Care Program, the estimated annual incidence was 15.6 patients/100,000 (women, 22.6; men, 8.0).

• #84

  https://journals.lww.com/ajg/fulltext/2015/01000/acg_clinical_guideline__epidemiology,_risk.8.aspx

  The absence of a unique diagnosis code for acute large bowel ischemia in the ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) challenges case finding for research. […] CI, the term we prefer to ischemic colitis because some patients do not have a documented inflammatory phase of disease, is the etiology in 924% of all patients hospitalized for acute lower gastrointestinal bleeding, ranking CI first, second, or third behind colorectal malignancy in large epidemiological surveys. […] A national insurance claims-based survey of patients hospitalized with CI revealed an annual incidence rate of 17.7 cases/100,000. […] In the population-based, record-review study of patients hospitalized in the Kaiser San Diego Medical Care Program, the estimated annual incidence was 15.6 patients/100,000 (women, 22.6; men, 8.0).

• #85

  https://journals.lww.com/ajg/fulltext/2015/01000/acg_clinical_guideline__epidemiology,_risk.8.aspx

  The absence of a unique diagnosis code for acute large bowel ischemia in the ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) challenges case finding for research. […] CI, the term we prefer to ischemic colitis because some patients do not have a documented inflammatory phase of disease, is the etiology in 924% of all patients hospitalized for acute lower gastrointestinal bleeding, ranking CI first, second, or third behind colorectal malignancy in large epidemiological surveys. […] A national insurance claims-based survey of patients hospitalized with CI revealed an annual incidence rate of 17.7 cases/100,000. […] In the population-based, record-review study of patients hospitalized in the Kaiser San Diego Medical Care Program, the estimated annual incidence was 15.6 patients/100,000 (women, 22.6; men, 8.0).

• #86 Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-017-0150-5

  Severe abdominal pain out of proportion to physical examination findings should be assumed to be AMI until disproven. (Recommendation 1B) […] The overall incidence is low (0.09 to 0.2% of all acute admissions to emergency departments), representing an uncommon cause of abdominal pain. […] Prompt diagnostic and intervention are essential to reduce the high mortality rates (50 to 80%). […] There are currently no level 1 evidence to guide the evaluation and treatment of suspected AMI, and the published literature contains primarily institutional reviews, case series and personal recommendations with no clearly defined treatment guidelines. […] Non-occlusive mesenteric ischemia (NOMI) should be suspected in critically ill patients with abdominal pain or distension requiring vasopressor support and evidence of multi-organ dysfunction. (Recommendation 1B)

• #87 Mesenteric ischemia epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Mesenteric_ischemia_epidemiology_and_demographics

  The incidence rate of mesenteric ischemia secondary to superior mesenteric artery occlusion is 8.6/100 000/year. 70% of SMA occlusion is caused by embolism and 30% by thrombosis. The annual incidence of mesenteric ischemia is approximately 5.5% per 100,000 individuals. The incidence of mesenteric ischemia increases with age and the median age at diagnosis is 70 years. Mesenteric ischemia affects men and women equally. […] The incidence due to non-occlusive mesenteric ischemia is 2/100,000 persons and 1.8/100,000 per person due to mesenteric venous thrombosis. In the United States, between 1995-2010 incidence of mesenteric ischemia declined from 8.4 to 6.7% per 100,000 individuals. […] Between the year 1970 and 1982, in the population of Sweden, the incidence of mesenteric ischemia was estimated to be 12.9 cases per 100,000 individuals.

• #88 Mesenteric ischemia epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Mesenteric_ischemia_epidemiology_and_demographics

  The prevalence of mesenteric ischemia: Occlusive mesenteric ischemia due to mesenteric venous thrombosis is approximately per 100,000 individuals worldwide. Non-occlusive mesenteric ischemia is approximately 6000 per 100,000 individuals worldwide. […] In 2017, the incidence of mesenteric ischemia is approximately 90-200 per 100,000 of all the surgical admissions with a mortality rate of 50%. […] The incidence of mesenteric ischemia increases with age and the median age at diagnosis is 70 years. Mesenteric ischemia commonly affects individuals older than 60 years of age, a few cases are reported in their 20s. […] There is no racial predilection to mesenteric ischemia. Mesenteric ischemia usually affects individuals of the African American race because of their higher predilection towards developing atherosclerosis. […] Mesenteric ischemia is more prevalent in women as compared to males. […] The majority of mesenteric ischemia cases are reported in Sweden.

• #89 Mesenteric ischemia epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Mesenteric_ischemia_epidemiology_and_demographics

  The incidence rate of mesenteric ischemia secondary to superior mesenteric artery occlusion is 8.6/100 000/year. 70% of SMA occlusion is caused by embolism and 30% by thrombosis. The annual incidence of mesenteric ischemia is approximately 5.5% per 100,000 individuals. The incidence of mesenteric ischemia increases with age and the median age at diagnosis is 70 years. Mesenteric ischemia affects men and women equally. […] The incidence due to non-occlusive mesenteric ischemia is 2/100,000 persons and 1.8/100,000 per person due to mesenteric venous thrombosis. In the United States, between 1995-2010 incidence of mesenteric ischemia declined from 8.4 to 6.7% per 100,000 individuals. […] Between the year 1970 and 1982, in the population of Sweden, the incidence of mesenteric ischemia was estimated to be 12.9 cases per 100,000 individuals.

• #90 Acute Mesenteric Ischemia: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/189146-overview

  Approximately two thirds of patients are women. […] Research indicates that inflammatory bowel disease (IBD) is another risk factor for mesenteric artery thrombosis. […] In a review comparing 17,487 patients who had either Crohn disease or ulcerative colitis with 69,948 control subjects, the investigators detected a significantly higher risk of AMI in the patients with IBD. […] Outside the United States, reported rates of AMI are probably lower in countries with limited diagnostic capability or whose populations have a shorter life expectancy because AMI is primarily a disease of older individuals.

• #91 Acute Mesenteric Ischemia: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/189146-overview

  Approximately two thirds of patients are women. […] Research indicates that inflammatory bowel disease (IBD) is another risk factor for mesenteric artery thrombosis. […] In a review comparing 17,487 patients who had either Crohn disease or ulcerative colitis with 69,948 control subjects, the investigators detected a significantly higher risk of AMI in the patients with IBD. […] Outside the United States, reported rates of AMI are probably lower in countries with limited diagnostic capability or whose populations have a shorter life expectancy because AMI is primarily a disease of older individuals.

• #92 Mesenteric ischemia epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Mesenteric_ischemia_epidemiology_and_demographics

  The prevalence of mesenteric ischemia: Occlusive mesenteric ischemia due to mesenteric venous thrombosis is approximately per 100,000 individuals worldwide. Non-occlusive mesenteric ischemia is approximately 6000 per 100,000 individuals worldwide. […] In 2017, the incidence of mesenteric ischemia is approximately 90-200 per 100,000 of all the surgical admissions with a mortality rate of 50%. […] The incidence of mesenteric ischemia increases with age and the median age at diagnosis is 70 years. Mesenteric ischemia commonly affects individuals older than 60 years of age, a few cases are reported in their 20s. […] There is no racial predilection to mesenteric ischemia. Mesenteric ischemia usually affects individuals of the African American race because of their higher predilection towards developing atherosclerosis. […] Mesenteric ischemia is more prevalent in women as compared to males. […] The majority of mesenteric ischemia cases are reported in Sweden.

• #93 Mesenteric ischemia epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Mesenteric_ischemia_epidemiology_and_demographics

  The prevalence of mesenteric ischemia: Occlusive mesenteric ischemia due to mesenteric venous thrombosis is approximately per 100,000 individuals worldwide. Non-occlusive mesenteric ischemia is approximately 6000 per 100,000 individuals worldwide. […] In 2017, the incidence of mesenteric ischemia is approximately 90-200 per 100,000 of all the surgical admissions with a mortality rate of 50%. […] The incidence of mesenteric ischemia increases with age and the median age at diagnosis is 70 years. Mesenteric ischemia commonly affects individuals older than 60 years of age, a few cases are reported in their 20s. […] There is no racial predilection to mesenteric ischemia. Mesenteric ischemia usually affects individuals of the African American race because of their higher predilection towards developing atherosclerosis. […] Mesenteric ischemia is more prevalent in women as compared to males. […] The majority of mesenteric ischemia cases are reported in Sweden.

• #94 Biochemical markers of acute intestinal ischemia: possibilities and limitations

  https://atm.amegroups.org/article/view/20595/html

  Acute intestinal ischemia is a relative rare abdominal emergency, associated with considerably high morbidity and mortality rates. […] The mortality usually ranges between 60-80% depending on etiology, age and diagnostic delay. […] Overall, this condition represents less than 1% of all acute admissions to emergency departments, but a rapid diagnosis and therapeutic management are compelling for adequately restoring blood flow and preventing intestine necrosis, up to patient death. […] Despite ample research in this field, early, sensitive and specific biomarkers of acute intestinal ischemia have not been identified so far. […] The aim of this narrative review is hence to provide an overview on traditional laboratory biomarkers of acute intestinal ischemia and summarize current evidence regarding some emerging and potentially useful biomarkers.

• #95 What is bowel ischaemia? – Heart Matters magazine – BHF

  https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/ask-the-experts/bowel-ischaemia

  Ischaemic bowel is a rare circulatory condition which can be linked with other heart and circulatory diseases. It comes in different forms. […] Serious cases are relatively rare, although theres a lack of good evidence about exactly how common it is. The available figures suggest that ischaemic bowel and similar conditions cause 5-6,000 hospital admissions and 3,000 deaths in the UK each year. […] The majority of people affected are over 50, and it is more common in women. […] When the bowel arteries are scanned in patients who have previously had a heart attack or stroke, around one person in eight has some disease in their bowel arteries. […] In patients with peripheral arterial disease (problems with arteries in the feet and legs), about one in four have bowel artery disease. […] However most of these patients dont have any symptoms and the condition is mild. […] We do not know exactly how many of these patients do go on to develop symptoms but evidence suggests it is small, less than 1 in 20.

• #96 Bowel Ischaemia | Doctor

  https://patient.info/doctor/bowel-ischaemia

  How common is acute mesenteric ischaemia? (epidemiology) […] This is chiefly a disease of people aged over 50, although younger people with risk factors for mesenteric venous thrombosis (MVT) – eg, atrial fibrillation (AF) – can be affected. The overall incidence is low – around 0.09-0.2% of all hospital admissions – but is a common indication for emergency intestinal resection.1 […] How common is chronic mesenteric ischaemia? (Epidemiology) […] Chronic mesenteric ischaemia has a very low incidence, accounting for less than 1 in 1,000 hospital admissions for abdominal pain.3 […] How common is ischaemic colitis? (Epidemiology) […] The incidence of ischaemic colitis rose from 6.1 cases/100000 person-years in 1976-80 to 22.9/100000 in 2005-09.6 Many mild cases may go unreported. […] Because the most common cause is atheroma of the mesenteric vessels it is mainly a disease of the elderly and is rare before the age of 60. […] The average age for diagnosis is 70. The incidence is likely to increase with the increasing age of the population. The condition is, however, by no means unknown in younger age groups, due to non-cardiovascular causes such as cocaine abuse.

• #97 Intestinal Ischemia and Gangrene | IntechOpen

  https://www.intechopen.com/chapters/18916

  The timely use of diagnostic and therapeutic methods to quickly restore blood flow to the bowel is the key to reduce the high mortality associated with this condition. […] Survival drops rapidly from 50% when the diagnosis is made within 24 hours to 30% or less when the diagnosis is delayed. […] The treatment of patients with acute mesenteric artery thrombosis is principally surgical. Surgical thrombectomy alone is unlikely to be successful in the long term. […] The management of NOMI is essentially pharmacological and is achieved by local selective infusion of vasodilators into the superior mesenteric artery (papaverine, tolazoline, nitroglycerin, glucagon, prostaglandin E and isoproterenol). […] The goal of therapy for chronic mesenteric ischemia is revascularization.

• #98 Mesenteric Ischemia: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23246-mesenteric-ischemia

  Mesenteric ischemia is more common as people age. It usually happens along with heart and circulation conditions, especially ones that can cause blood clots. […] Mesenteric ischemia is a rare issue. The estimated number of cases is 1 to 2 for every 1,000 cases where someone needs hospitalization. […] Unfortunately, mesenteric ischemia in any form is a difficult condition to diagnose. Waiting for a diagnosis can delay treatment, and when treatment doesn’t happen quickly, acute mesenteric ischemia is often deadly. The death rate for the acute version of this condition is between 50% and 80%, especially when there are delays in treatment. When treatment happens in under 12 hours from when the blockage started, the death rate can be as low as 14%. Chronic mesenteric ischemia can also have long-term negative effects, either because of the risk of follow-up blood flow problems or nutrition difficulties.

• #99 Acute Mesenteric Ischemia: Epidemiology, Pathophysiology, Clinical Evaluation, and Management – Clinical Tree

  https://clinicalpub.com/acute-mesenteric-ischemia-epidemiology-pathophysiology-clinical-evaluation-and-management/

  Acute mesenteric ischemia accounts for less than 1 of every 1000 hospital admissions. This disease process affects women three times as frequently as men and is typically seen in elderly patients with multiple comorbidities. […] Clinical risk factors often provide clues to the specific pathophysiology. Patients at risk for mesenteric embolus include those with a history of atrial fibrillation/flutter, recent myocardial infarction, congestive heart failure, or peripheral arterial emboli. […] While historical data noted arterial embolism to be the most common cause of acute mesenteric ischemia, recent studies have suggested that in situ thrombosis of chronic lesions may now account for greater than 50% of cases of acute mesenteric ischemia. […] Mesenteric vasospasm, usually in the distribution of the SMA, is the sine qua non of Nonocclusive Mesenteric Ischemia (NOMI). This form of AMI accounts for approximately 20% of presentations, but carries the highest mortality rates. […] Delays in diagnosis and treatment remain the greatest challenge to reducing morbidity and mortality for all forms of mesenteric ischemia.

• #100 Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-017-0150-5

  Severe abdominal pain out of proportion to physical examination findings should be assumed to be AMI until disproven. (Recommendation 1B) […] The overall incidence is low (0.09 to 0.2% of all acute admissions to emergency departments), representing an uncommon cause of abdominal pain. […] Prompt diagnostic and intervention are essential to reduce the high mortality rates (50 to 80%). […] There are currently no level 1 evidence to guide the evaluation and treatment of suspected AMI, and the published literature contains primarily institutional reviews, case series and personal recommendations with no clearly defined treatment guidelines. […] Non-occlusive mesenteric ischemia (NOMI) should be suspected in critically ill patients with abdominal pain or distension requiring vasopressor support and evidence of multi-organ dysfunction. (Recommendation 1B)

• #101 Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-017-0150-5

  Severe abdominal pain out of proportion to physical examination findings should be assumed to be AMI until disproven. (Recommendation 1B) […] The overall incidence is low (0.09 to 0.2% of all acute admissions to emergency departments), representing an uncommon cause of abdominal pain. […] Prompt diagnostic and intervention are essential to reduce the high mortality rates (50 to 80%). […] There are currently no level 1 evidence to guide the evaluation and treatment of suspected AMI, and the published literature contains primarily institutional reviews, case series and personal recommendations with no clearly defined treatment guidelines. […] Non-occlusive mesenteric ischemia (NOMI) should be suspected in critically ill patients with abdominal pain or distension requiring vasopressor support and evidence of multi-organ dysfunction. (Recommendation 1B)

• #102 Epidemiology, Risk Factors, Patterns of Presentation, Diagnosis, and Management of Colon Ischemia (CI)

  https://www.mdcalc.com/guidelines/10374/acg/epidemiology-risk-factors-patterns-presentation-diagnosis-management-colon-ischemia-ci

  The diagnosis of CI is usually established in the presence of symptoms including sudden cramping, mild, abdominal pain; an urgent desire to defecate; and passage within 24 h of bright red or maroon blood or bloody diarrhea. […] A diagnosis of non-isolated right colon ischemia (non-IRCI) should be considered when patients present with hematochezia. […] CT with intravenous and oral contrast should be the first imaging modality of choice for patients with suspected CI to assess the distribution and phase of colitis. […] The diagnosis of CI can be suggested based on CT findings (e.g., bowel wall thickening, edema, thumbprinting). […] Multiphasic CTA should be performed on any patient with suspected IRCI or in any patient in whom the possibility of AMI cannot be excluded. […] CT or MRI findings of colonic pneumatosis and porto-mesenteric venous gas can be used to predict the presence of transmural colonic infarction.

• #103 Epidemiology, Risk Factors, Patterns of Presentation, Diagnosis, and Management of Colon Ischemia (CI)

  https://www.mdcalc.com/guidelines/10374/acg/epidemiology-risk-factors-patterns-presentation-diagnosis-management-colon-ischemia-ci

  In a patient in whom the presentation of CI may be a heralding sign of AMI (e.g., IRCI, severe pain without bleeding, atrial fibrillation), and the multiphasic CT is negative for vascular occlusive disease, traditional splanchnic angiography should be considered for further assessment. […] Early colonoscopy (within 48 h of presentation) should be performed in suspected CI to confirm the diagnosis. […] In patients with severe CI, CT should be used to evaluate the distribution of disease. Limited colonoscopy is appropriate to confirm the nature of the CT abnormality. Colonoscopy should be halted at the distalmost extent of the disease. […] Most cases of CI resolve spontaneously and do not require specific therapy. […] Surgical intervention should be considered in the presence of CI accompanied by hypotension, tachycardia, and abdominal pain without rectal bleeding; for IRCI and pan-colonic CI; and in the presence of gangrene. […] Antimicrobial therapy should be considered for patients with moderate or severe disease.

• #104 Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-017-0150-5

  Severe abdominal pain out of proportion to physical examination findings should be assumed to be AMI until disproven. (Recommendation 1B) […] The overall incidence is low (0.09 to 0.2% of all acute admissions to emergency departments), representing an uncommon cause of abdominal pain. […] Prompt diagnostic and intervention are essential to reduce the high mortality rates (50 to 80%). […] There are currently no level 1 evidence to guide the evaluation and treatment of suspected AMI, and the published literature contains primarily institutional reviews, case series and personal recommendations with no clearly defined treatment guidelines. […] Non-occlusive mesenteric ischemia (NOMI) should be suspected in critically ill patients with abdominal pain or distension requiring vasopressor support and evidence of multi-organ dysfunction. (Recommendation 1B)

• #105

  https://journals.lww.com/ajg/fulltext/2015/01000/acg_clinical_guideline__epidemiology,_risk.8.aspx

  A recently published population-based study yielded an incidence of 16.3 cases/100,000 person-years with a nearly fourfold increase over 34 years. […] CI occurs in adults of all ages and increases with age, especially after age 49 years. […] CI is more common in women than in men, and 5776% of patients in large series have been female. […] Mortality rates in large series range from 4 to 12%, but inclusion criteria, case ascertainment methods, and rates of comorbidity and surgery in these studies differed. […] Recurrent CI increases over time; for example, estimated cumulative recurrence rates at 1, 23, 4, and 56 years were 3%, 5%, 6%, and 10%, respectively, in one study and 3.3% at 2 years and 7.5% at 5 years in another study. […] Therefore, in any large survey, recurrence will be related to the relative proportions of patients with spontaneous, idiopathic disease and those with illnesses likely to foster recurrence.

• #106 Mesenteric ischemia epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Mesenteric_ischemia_epidemiology_and_demographics

  The incidence rate of mesenteric ischemia secondary to superior mesenteric artery occlusion is 8.6/100 000/year. 70% of SMA occlusion is caused by embolism and 30% by thrombosis. The annual incidence of mesenteric ischemia is approximately 5.5% per 100,000 individuals. The incidence of mesenteric ischemia increases with age and the median age at diagnosis is 70 years. Mesenteric ischemia affects men and women equally. […] The incidence due to non-occlusive mesenteric ischemia is 2/100,000 persons and 1.8/100,000 per person due to mesenteric venous thrombosis. In the United States, between 1995-2010 incidence of mesenteric ischemia declined from 8.4 to 6.7% per 100,000 individuals. […] Between the year 1970 and 1982, in the population of Sweden, the incidence of mesenteric ischemia was estimated to be 12.9 cases per 100,000 individuals.

• #107 Acute Mesenteric Ischemia: Epidemiology, Pathophysiology, Clinical Evaluation, and Management – Clinical Tree

  https://clinicalpub.com/acute-mesenteric-ischemia-epidemiology-pathophysiology-clinical-evaluation-and-management/

  Acute mesenteric ischemia accounts for less than 1 of every 1000 hospital admissions. This disease process affects women three times as frequently as men and is typically seen in elderly patients with multiple comorbidities. […] Clinical risk factors often provide clues to the specific pathophysiology. Patients at risk for mesenteric embolus include those with a history of atrial fibrillation/flutter, recent myocardial infarction, congestive heart failure, or peripheral arterial emboli. […] While historical data noted arterial embolism to be the most common cause of acute mesenteric ischemia, recent studies have suggested that in situ thrombosis of chronic lesions may now account for greater than 50% of cases of acute mesenteric ischemia. […] Mesenteric vasospasm, usually in the distribution of the SMA, is the sine qua non of Nonocclusive Mesenteric Ischemia (NOMI). This form of AMI accounts for approximately 20% of presentations, but carries the highest mortality rates. […] Delays in diagnosis and treatment remain the greatest challenge to reducing morbidity and mortality for all forms of mesenteric ischemia.

• #108 Intestinal Ischemia | Abdominal Key

  https://abdominalkey.com/intestinal-ischemia/

  Intestinal ischemia produces a broad spectrum of disorders, depending on the onset, duration, and cause of the injury; the area and length of bowel affected; the vessel involved; and the degree of collateral blood flow. […] Since the development and widespread use of colonoscopy, angiography, computed tomography (CT), and other imaging modalities, various types of ischemic injury to the gastrointestinal tract have been recognized and increasingly appreciated. […] AMI accounts for about 0.1% of admissions to our tertiary care center. […] Most series of AMI reported in the late 1970s and early 1980s showed that SMAE was responsible for 40% to 50%, NOMI for 20% to 30%, and SMAT for 10% to 20% of cases. […] The incidence of NOMI has now declined, however, likely because intensive care unit monitoring enables prompt correction of hypotension and blood volume deficits.

• #109 Bowel Ischaemia | Doctor

  https://patient.info/doctor/bowel-ischaemia

  How common is acute mesenteric ischaemia? (epidemiology) […] This is chiefly a disease of people aged over 50, although younger people with risk factors for mesenteric venous thrombosis (MVT) – eg, atrial fibrillation (AF) – can be affected. The overall incidence is low – around 0.09-0.2% of all hospital admissions – but is a common indication for emergency intestinal resection.1 […] How common is chronic mesenteric ischaemia? (Epidemiology) […] Chronic mesenteric ischaemia has a very low incidence, accounting for less than 1 in 1,000 hospital admissions for abdominal pain.3 […] How common is ischaemic colitis? (Epidemiology) […] The incidence of ischaemic colitis rose from 6.1 cases/100000 person-years in 1976-80 to 22.9/100000 in 2005-09.6 Many mild cases may go unreported. […] Because the most common cause is atheroma of the mesenteric vessels it is mainly a disease of the elderly and is rare before the age of 60. […] The average age for diagnosis is 70. The incidence is likely to increase with the increasing age of the population. The condition is, however, by no means unknown in younger age groups, due to non-cardiovascular causes such as cocaine abuse.

• #110 Bowel Ischaemia | Doctor

  https://patient.info/doctor/bowel-ischaemia

  How common is acute mesenteric ischaemia? (epidemiology) […] This is chiefly a disease of people aged over 50, although younger people with risk factors for mesenteric venous thrombosis (MVT) – eg, atrial fibrillation (AF) – can be affected. The overall incidence is low – around 0.09-0.2% of all hospital admissions – but is a common indication for emergency intestinal resection.1 […] How common is chronic mesenteric ischaemia? (Epidemiology) […] Chronic mesenteric ischaemia has a very low incidence, accounting for less than 1 in 1,000 hospital admissions for abdominal pain.3 […] How common is ischaemic colitis? (Epidemiology) […] The incidence of ischaemic colitis rose from 6.1 cases/100000 person-years in 1976-80 to 22.9/100000 in 2005-09.6 Many mild cases may go unreported. […] Because the most common cause is atheroma of the mesenteric vessels it is mainly a disease of the elderly and is rare before the age of 60. […] The average age for diagnosis is 70. The incidence is likely to increase with the increasing age of the population. The condition is, however, by no means unknown in younger age groups, due to non-cardiovascular causes such as cocaine abuse.

• #111 Many faces of acute bowel ischemia: overview of radiologic staging | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1186/s13244-021-00985-9

  Acute bowel ischemia (ABI) can be life threatening with high mortality rate. In spite of the advances made in diagnosis and treatment of ABI, no significant change has occurred in the mortality over the past decade. […] Despite low incidence (accounting for only 0.090.2% of emergency departments admissions), this is a life-threatening condition with mortality rate reaching 6080%, even with surgical intervention. In spite of advances in detection and therapeutic options, no significant change has occurred in the mortality of ABI over the past decade. […] Understanding the pathologic basis of ABI can help to estimate the probability of reversibility and choose the optimal treatment option. […] The management of ABI is summarized as 3Rs, Resuscitation, Rapid diagnosis and Revascularization.

• #112

  https://link.springer.com/article/10.1007/s00268-022-06805-5

  There is a lack of population-based studies on acute mesenteric ischemia (AMI). […] We have therefore performed a nationwide epidemiological study in Estonia, addressing incidence, demographics, interventions and mortality of AMI. […] Overall, 577 cases of AMI were identifiedan annual incidence of 8.7 per 100,000. […] The population-based annual incidence of AMI in Estonia was 8.7 per 100,000 during the study period. […] The overall hospital mortality and 1 year mortality were 64% and 74%, respectively. […] In the 53% of patients who received active treatment hospital mortality was 32% and 1 year all-cause mortality was 51%.

• #113

  https://journals.lww.com/ajg/fulltext/2015/01000/acg_clinical_guideline__epidemiology,_risk.8.aspx

  A recently published population-based study yielded an incidence of 16.3 cases/100,000 person-years with a nearly fourfold increase over 34 years. […] CI occurs in adults of all ages and increases with age, especially after age 49 years. […] CI is more common in women than in men, and 5776% of patients in large series have been female. […] Mortality rates in large series range from 4 to 12%, but inclusion criteria, case ascertainment methods, and rates of comorbidity and surgery in these studies differed. […] Recurrent CI increases over time; for example, estimated cumulative recurrence rates at 1, 23, 4, and 56 years were 3%, 5%, 6%, and 10%, respectively, in one study and 3.3% at 2 years and 7.5% at 5 years in another study. […] Therefore, in any large survey, recurrence will be related to the relative proportions of patients with spontaneous, idiopathic disease and those with illnesses likely to foster recurrence.

• #114 Acute Mesenteric Ischemia: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/189146-overview

  AMI is believed to account for 0.1% of all hospital admissions; this figure may be expected to rise as the population ages. Annual incidence in the general population has been reported to be in the range of 0.63-12.9 per 100,000. […] The exact prevalence of MVT is not known, because many cases are presumed to be limited in symptomatology and to resolve spontaneously. It is believed to account for approximately 10-15% of all cases of mesenteric ischemia and for 0.006% of hospital admissions. Venous thrombosis is found in approximately 0.001% of patients who undergo exploratory laparotomy. […] Risk factors for AMI include atherosclerosis, arrhythmias, hypovolemia, CHF, recent MI, valvular disease, advanced age, and intra-abdominal malignancy. […] Mesenteric artery stenosis is found in 17.5% of independent elderly adults.

• #115

  https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-gastrointestinal/mesenteric-ischemia

  Mesenteric ischemia remains a very difficult disease process to identify early. […] The incidence may be rising because of an aging population with significant co-morbidities such as atrial fibrillation, atherosclerosis, congestive heart failure, and hypercoagulability. […] The importance of early consideration and diagnosis of mesenteric ischemia cannot be overemphasized. […] The classic presentation for mesenteric ischemia will be in a patient over the age of 60. […] Women are three times more likely than men to have acute mesenteric ischemia. […] The mortality rate for mesenteric ischemia remains high despite new diagnostic testing. […] The four causes of mesenteric ischemia are mesenteric artery embolism (commonly due to atrial fibrillation), mesenteric artery thrombosis (commonly due to atherosclerosis), mesenteric vein thrombosis (commonly due to hypercoagulability) and non-occlusive mesenteric ischemia (commonly due to low flow states). […] CT angiography has replaced mesenteric angiography as the initial imaging study due to being less invasive, readily available, and having the ability to diagnose other causes for abdominal pain.

• #116 Many faces of acute bowel ischemia: overview of radiologic staging | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1186/s13244-021-00985-9

  Acute bowel ischemia (ABI) can be life threatening with high mortality rate. In spite of the advances made in diagnosis and treatment of ABI, no significant change has occurred in the mortality over the past decade. […] Despite low incidence (accounting for only 0.090.2% of emergency departments admissions), this is a life-threatening condition with mortality rate reaching 6080%, even with surgical intervention. In spite of advances in detection and therapeutic options, no significant change has occurred in the mortality of ABI over the past decade. […] Understanding the pathologic basis of ABI can help to estimate the probability of reversibility and choose the optimal treatment option. […] The management of ABI is summarized as 3Rs, Resuscitation, Rapid diagnosis and Revascularization.

• #117 Bowel Ischaemia | Doctor

  https://patient.info/doctor/bowel-ischaemia

  How common is acute mesenteric ischaemia? (epidemiology) […] This is chiefly a disease of people aged over 50, although younger people with risk factors for mesenteric venous thrombosis (MVT) – eg, atrial fibrillation (AF) – can be affected. The overall incidence is low – around 0.09-0.2% of all hospital admissions – but is a common indication for emergency intestinal resection.1 […] How common is chronic mesenteric ischaemia? (Epidemiology) […] Chronic mesenteric ischaemia has a very low incidence, accounting for less than 1 in 1,000 hospital admissions for abdominal pain.3 […] How common is ischaemic colitis? (Epidemiology) […] The incidence of ischaemic colitis rose from 6.1 cases/100000 person-years in 1976-80 to 22.9/100000 in 2005-09.6 Many mild cases may go unreported. […] Because the most common cause is atheroma of the mesenteric vessels it is mainly a disease of the elderly and is rare before the age of 60. […] The average age for diagnosis is 70. The incidence is likely to increase with the increasing age of the population. The condition is, however, by no means unknown in younger age groups, due to non-cardiovascular causes such as cocaine abuse.

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