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%.

• #1 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.

• #1 Epidemiology of Acute Mesenteric Ischemia: A Population-Based Investigation – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36261602/

  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 identified-an 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%.

• #1 Incidence, diagnosis, management and outcome of acute mesenteric ischaemia: a prospective, multicentre observational study (AMESI Study) | Critical Care | Full Text

  https://ccforum.biomedcentral.com/articles/10.1186/s13054-024-04807-4

  The aim of this multicentre prospective observational study was to identify the incidence, patient characteristics, diagnostic pathway, management and outcome of acute mesenteric ischaemia (AMI). […] AMI occurred in 0.038% of adult admissions in participating acute care hospitals worldwide. […] The overall incidence of AMI and AMI subtypes varies worldwide, and case ascertainment is challenging. […] A recent survey has identified delay in diagnosis of AMI and heterogeneity in management approaches as contributing to poor outcomes. […] The overall occurrence rate of confirmed AMI was lower than anticipated based on previous analyses. […] The distribution of different subtypes of AMI was largely similar to literature data, but the degree of diagnostic uncertainty was surprising in this prospective study.

• #1 Improving the ED Diagnosis of Mesenteric Ischemia – emDocs

  https://www.emdocs.net/improving-the-ed-diagnosis-of-mesenteric-ischemia/

  Mesenteric ischemia remains a high mortality and easily missed diagnosis in emergency medicine. A rare disease accounting for fewer than 1 in 1000 hospital admissions, it develops as a result of insufficient mesenteric blood flow to the visceral organs. […] Mesenteric ischemia appears significantly more commonly in the elderly. Incidence rate can be understood as the risk of developing a disease over a relevant time period. […] In a retrospective, single-center analysis of a well-defined Finnish population, inhabitants older than 75 years had an incidence rate (cases/100,000 persons/year) of 51.2 for mesenteric ischemia compared to 40.2 for acute appendicitis.

• #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

  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 key to early diagnosis is a high level of clinical suspicion. […] The classic presentation of AMI, i.e., severe, poorly localized abdominal pain that is out of proportion to the physical examination, is becoming less common, while the acute on chronic presentations of mesenteric ischemia are more typical, and probably underdiagnosed. […] Recent published evidence suggests that treatment of occlusive AMI in intestine stroke centers using a multidisciplinary approach improves outcomes. […] The management of patients with AMI is summarized in Fig. 1.

• #1 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.

• #1 Mesenteric Ischemia | Concise Medical Knowledge

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

  Exact prevalence is unknown. […] Accounts for 0.1% of all hospital admissions. […] Generally seen in patients 60-years-old. […] Mortality rate: 60%. […] Chronic mesenteric ischemia is rare. […] 60% of cases are inpatients 60-years-old. […] More common in women.

• #1 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. Younger age group having risk factors such as atrial fibrillation or other hypercoagulable states such as protein C and protein S deficiency are also predisposed to the risk.

• #1 Epidemiology and Pathophysiology of Mesenteric Vascular Disease | Clinical Gate

  https://clinicalgate.com/epidemiology-and-pathophysiology-of-mesenteric-vascular-disease/

  Nonocclusive mesenteric ischemia (NOMI) accounts for 25% of all episodes of acute intestinal ischemia. […] Previous reports have identified multiple risk factors for development of NOMI. […] Mesenteric venous thrombosis is a comparatively rare form of mesenteric ischemia. […] Mesenteric venous thrombosis currently constitutes no more than 5% to 15% of all cases of acute mesenteric ischemia. […] Chronic mesenteric ischemia results from atherosclerosis in 90% of cases. […] Risk factors for atherosclerotic-associated CMI are similar to those of other atherosclerotic conditions, including a positive family history, sedentary lifestyle, hypertension, hypercholesterolemia, and smoking. […] Approximately 60% of patients with CMI are female, and nearly 50% of patients have a history of earlier cardiovascular surgery. […] The prevalence of potentially flow-limiting stenosis within the mesenteric vessels increases with age, with up to 67% of those older than 80 years of age having more than 50% stenosis in some mesenteric artery.

• #1 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.

• #1 Mesenteric ischemia epidemiology and demographics – wikidoc

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

  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.

• #1 Delayed Diagnosis of Mesenteric Ischemia | PSNet

  https://psnet.ahrq.gov/web-mm/delayed-diagnosis-mesenteric-ischemia

  Mesenteric ischemia occurs when there is reduced blood flow to the small or large intestines from multiple potential etiologies involving interruptions of either the arterial or venous systems. […] The frequency of these major causes of mesenteric ischemia among all patients is estimated as: 50% mesenteric arterial embolism, 15-25% mesenteric arterial thrombosis, 5% mesenteric venous thrombosis, and 20-30% nonocclusive mesenteric ischemia. […] Given the potential for devastating outcomes when not diagnosed in a timely fashion, as in the presented case, mesenteric ischemia is an important diagnosis to consider in all patients with severe abdominal pain. […] Its chronic form most commonly affects women; more than 70% of patients with this disease are female. […] In patients with acute abdominal pain, it is important to assess for atherosclerotic risk factors and arrythmias, potential sources of embolus, and/or hypoperfusion, as this would increase clinical suspicion for this disorder. […] In the setting of chronic mesenteric ischemia, abdominal duplex ultrasound of the mesenteric vasculature can be used for monitoring and surveillance. […] Early diagnosis is critical in mesenteric ischemia and requires a mesenteric angiogram, usually by CT.

• #1 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. […] Recent reviews have shown significant declines in the in-hospital mortality rate among patients treated for acute mesenteric ischemia; however they remain high at 17%21% among patients requiring revascularization. […] Delays in diagnosis and treatment remain the greatest challenge to reducing morbidity and mortality for all forms of mesenteric ischemia.

• #1

  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 delay in diagnosis of mesenteric ischemia can be disastrous. […] Fortunately, mesenteric ischemia is not a common disease as it accounts for 1% of admissions to the hospital for acute abdominal processes. […] 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.

• #1 Acute mesenteric arterial occlusion – UpToDate

  https://www.uptodate.com/contents/acute-mesenteric-arterial-occlusion

  Acute mesenteric arterial occlusion accounts for 67 to 95 percent of cases of acute mesenteric ischemia. […] In one review, there has been a significant decrease in the percentage of embolic events since 2000. […] The two major causes of acute mesenteric arterial occlusion are mesenteric arterial embolism and mesenteric arterial thrombosis.

• #1 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. […] The prognosis of AMI is poor, with patients experiencing high morbidity and mortality rates. While there is a downward trend in mortality rates since the 1960s, the AMI mortality range remains high, occurring at rates between 60% and 80%. The specific AMI classification affects the likelihood of mortality, with acute embolism having a better prognosis, followed by NOMI and acute thrombosis. Factors associated with mortality include advanced age, bowel resection during second-look surgery, metabolic acidosis, renal insufficiency, and symptom duration.

• #1 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.

• #1 Veno-occlusive mesenteric ischemia | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/veno-occlusive-mesenteric-ischaemia?lang=us

  Compared to acute superior mesenteric artery occlusion, veno-occlusive causes of acute mesenteric ischemia are uncommon, accounting for only 5-15% of all cases of acute mesenteric ischemia. […] Approximately 30% (range 20-40%) of cases have no clear precipitant and are considered idiopathic.

• #1 Non-occlusive mesenteric ischemia | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/non-occlusive-mesenteric-ischaemia?lang=us

  Non-occlusive mesenteric ischemia is the second most common cause of acute mesenteric ischemia, with a higher incidence in hospitalized and critical care patients. […] Non-occlusive mesenteric ischemia accounts for ~25% (range 20-30%) of acute mesenteric ischemia. It most commonly affects patients 50 years.

• #1 An Overview of Acute Mesenteric Ischemia | Applied Radiology

  https://appliedradiology.com/articles/an-overview-of-acute-mesenteric-ischemia

  Acute mesenteric ischemia (AMI), a surgical emergency, is an uncommon but serious condition that accounts for 1 in 1000 hospital admissions in the United States and Europe and has extremely high mortality rates, ranging between 50 and 69%. Mortality remains high despite advances in diagnostic and treatment options, including the advent and widespread use of multidetector computed tomography (MDCT). […] The incidence of AMI is increasing, owing partly to increased recognition and diagnosis, but more so to the increase in the aging population, with its cardiovascular and/or systemic diseases that further accentuate AMI risk. Early diagnosis and management are of utmost importance given AMI’s prevalence in the elderly population, who often have worse prognoses due to comorbidities. […] NOMI is often associated with the worst outcomes, reaching mortality rates of 58-70%.

• #1 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.

• #1 EM@3AM: Mesenteric Ischemia – emDocs

  https://www.emdocs.net/em3am-mesenteric-ischemia/

  Epidemiology: […] 0.09% incidence annually […] Mortality within first 24 hours 60-80% […] Time is crucial in mortality […] Mortality 70% if time to diagnosis > 24 hours […] Mortality 14% if surgical intervention without 12 hours of symptom onset […] Comorbidity Prevalence: […] Peripheral Arterial Disease 27% […] Coronary Artery Disease 46% […] HTN, HLD, DM, and obesity also common […] 14%/year risk of mesenteric ischemia secondary to atrial fibrillation CITE (2.3%/year stroke risk) […] […] […] The majority of cases of acute mesenteric ischemia are the result of acute arterial occlusion resulting from embolization from the heart. Risk factors include dysrhythmias (particularly atrial fibrillation), atherosclerosis, valvular heart disease and recent myocardial infarction. The superior mesenteric artery is most frequently affected in acute arterial occlusion. This artery supplies the distal half of the duodenum to the proximal two-thirds of the transverse colon. It is likely the most commonly involved artery due to its large caliber and narrow takeoff angle from the aorta. In addition to an acute embolic event, mesenteric ischemia can be due to progression of atherosclerotic disease with arterial or venous thrombosis, or nonocclusive ischemia due to hypoperfusion or vasospasm. Patients with acute mesenteric ischemia due to arterial embolism present with sudden onset diffuse abdominal pain, vomiting and diarrhea. Early on, the pain is out of proportion to physical exam findings. As the ischemia progresses and infarct occurs, pain becomes more localized and peritoneal signs can be present. CT angiography is the imaging study of choice for diagnosis with a sensitivity and specificity of over 90%. Management includes fluid resuscitation, broad spectrum IV antibiotics and emergent surgical consultation.

• #1 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.

• #1 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

  Acute mesenteric ischaemia (AMI) is an uncommon condition that constitutes one of the abdominal emergencies with the worst prognosis. Its incidence increases with age and seems to be equal in men and women. It represents approximately one in every 1000 patients admitted to hospital for acute care. Its mortality rate is around 40-80%, due to the difficulty of early detection and the limited time that elapses between the decrease in vascular flow to the intestinal loops and the development of irreversible intestinal necrosis. The prognosis for these patients depends on the time to diagnosis and initiation of treatment. A delay in diagnosis of 24h decreases survival rates by up to 20%. Therefore, early diagnosis and rapid management are essential. In this regard, imaging tests play an important role, since, as shall be seen later on, neither symptoms nor laboratory tests are specific. At present, multidetector computed tomography (MDCT) is the initial imaging technique of choice for the diagnosis of suspected AMI and, in addition, enables other causes of acute abdominal pain to be ruled out.

• #1

  https://link.springer.com/article/10.1007/s00134-024-07363-1

  Acute mesenteric ischaemia (AMI) is diagnosed in 0.040.07% of adult hospital admissions, with a highly variable proportion (050%) of non-occlusive mesenteric ischaemia (NOMI) observed in different hospitals. […] The variable incidence most likely indicates differences in awareness. […] Mortality of AMI is globally still very high, with approximately 50% survival. […] Mortality is highest for NOMI and lowest for mesenteric venous thrombosis. […] It is believed that accurate serum/plasma biomarkers for early diagnosis of AMI are necessary to substantially improve outcomes.

• #1 Acute Mesenteric Ischemia – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/acute-mesenteric-ischemia

  Early diagnosis of mesenteric ischemia is particularly important because mortality increases significantly once intestinal infarction has occurred. […] Mesenteric ischemia must be considered in any patient 50 with known risk factors or predisposing conditions who develops sudden, severe abdominal pain. […] If diagnosis and treatment take place before infarction occurs, mortality is low; after intestinal infarction, mortality is high and varies depending on the etiology. […] For this reason, clinical diagnosis of mesenteric ischemia should supersede diagnostic tests, which may delay treatment. […] Early diagnosis is critical because mortality increases significantly once intestinal infarction has occurred.

• #1 Mesenteric ischemia: what the radiologist needs to know – Olson – Cardiovascular Diagnosis and Therapy

  https://cdt.amegroups.org/article/view/21705/html

  Mesenteric ischemia is an umbrella term encompassing a broad array of disorders causing insufficient blood flow to the abdominal viscera and has both acute and chronic variations (1-3). Though uncommon, accounting for 0.09% to 0.2% of acute surgical admissions (4), it remains a highly morbid condition, with reported mortality rates ranging from 30% to 90% (1). […] Diagnosis is challenging secondary to the rarity of the disease, its nonspecific clinical presentation, and often subtle or non-specific imaging findings (5,6). Consequently, a high index of suspicion on the part of the clinician and the radiologist, as well as familiarity with the spectrum of imaging findings associated with mesenteric ischemia, is required to ensure prompt recognition of the disease. […] Per the American College of Radiology (ACR) Appropriateness Criteria, computed tomographic angiography (CTA) is the first-line diagnostic modality for mesenteric ischemia (17). Rapid, widely available, and relatively inexpensive, CTA has a sensitivity of 96% and a specificity of 94% in the diagnosis of both the acute and chronic forms of mesenteric ischemia (17), while a recent analysis of CTA in the setting of AMI documented a sensitivity of 89%, a specificity of 99%, and positive and negative predictive values of 97% (18).

• #1 Mesenteric ischemia: what the radiologist needs to know – Olson – Cardiovascular Diagnosis and Therapy

  https://cdt.amegroups.org/article/view/21705/html

  Recent analyses suggest that use of dual-energy CT (DECT) may reduce radiation exposure and increase the accuracy of mesenteric ischemia diagnosis (19-24). The creation of iodine-selective, virtual noncontrast, and low keV monoenergetic images using dual-energy post-processing techniques enhances the conspicuity of differential bowel wall enhancement and identifies bowel wall hemorrhage, aiding in the recognition of ischemic segments (21,22).

• #1 Incidence, diagnosis, management and outcome of acute mesenteric ischaemia: a prospective, multicentre observational study (AMESI Study) | Critical Care | Full Text

  https://ccforum.biomedcentral.com/articles/10.1186/s13054-024-04807-4

  The overall mortality of approximately 50% was high, especially considering the prospective nature of the study and the focus on timely diagnosis and treatment. […] Low overall revascularization rate and large variations between the sites regarding incidence, baseline characteristics, management and outcome were observed, indicating the need for clearer guidance in diagnosis and management, but also in criteria for suspicion and diagnosis of AMI.

• #1 Chronic mesenteric ischemia: Clinical practice guidelines from the Society for Vascular Surgery

  https://scholarworks.indianapolis.iu.edu/items/e7e81a21-8db9-4969-b5ed-a06917eb9b96

  Chronic mesenteric ischemia (CMI) results from the inability to achieve adequate postprandial intestinal blood flow, usually from atherosclerotic occlusive disease at the origins of the mesenteric vessels. […] Long-term follow-up and surveillance are recommended after revascularization and for asymptomatic patients with severe mesenteric occlusive disease.

• #2 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 […] Most commonly (95%) caused by transient hypoperfusion due to nonocclusive disease […] Older patients with risk factors for atherosclerosis are at especially high risk for developing colon ischemia […] Severe abdominal pain and bloody diarrhea after an abdominal aortic aneurysm repair is a classic manifestation of colon ischemia […] Most commonly occurs in individuals 60 years of age […] Prevalence in patients with acute abdomen: 1% […] Mortality: 50-70% […] CMI most commonly occurs in adults 60 years of age […] MAOD is common, while CMI is rare […] 5-year mortality for untreated CMI is close to 100% […] Symptoms are relieved in 95% of patients following revascularization.

• #2 Multidetector computed tomography of mesenteric ischaemia | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1007/s13244-014-0361-1

  Mesenteric ischaemia comprises a broad, heterogeneous group of diseases characterised by inadequate blood supply to the small or large bowel. Acute mesenteric ischaemia is a surgical emergency, with significant associated morbidity and mortality. […] Mesenteric ischaemia predominantly affects the elderly, particularly those with comorbid conditions such as congestive heart failure, cardiac arrhythmias, valvular heart disease, coronary artery disease, peripheral vascular disease, dyslipida, recent myocardial infarction or hypotensive episode. […] In chronic mesenteric ischaemia, women are affected more often than men by a factor of 34:1. […] Bowel ischaemia accounts for approximately 0.1 % of all hospital admissions and 1.0 % of admissions for an acute abdomen. […] A high index of clinical and radiologic suspicion is required for prompt diagnosis and treatment.

• #2

  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.

• #2 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.

• #2 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.

• #2 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. Younger age group having risk factors such as atrial fibrillation or other hypercoagulable states such as protein C and protein S deficiency are also predisposed to the risk.

• #2 Delayed Diagnosis of Mesenteric Ischemia | PSNet

  https://psnet.ahrq.gov/web-mm/delayed-diagnosis-mesenteric-ischemia

  Mesenteric ischemia occurs when there is reduced blood flow to the small or large intestines from multiple potential etiologies involving interruptions of either the arterial or venous systems. […] The frequency of these major causes of mesenteric ischemia among all patients is estimated as: 50% mesenteric arterial embolism, 15-25% mesenteric arterial thrombosis, 5% mesenteric venous thrombosis, and 20-30% nonocclusive mesenteric ischemia. […] Given the potential for devastating outcomes when not diagnosed in a timely fashion, as in the presented case, mesenteric ischemia is an important diagnosis to consider in all patients with severe abdominal pain. […] Its chronic form most commonly affects women; more than 70% of patients with this disease are female. […] In patients with acute abdominal pain, it is important to assess for atherosclerotic risk factors and arrythmias, potential sources of embolus, and/or hypoperfusion, as this would increase clinical suspicion for this disorder. […] In the setting of chronic mesenteric ischemia, abdominal duplex ultrasound of the mesenteric vasculature can be used for monitoring and surveillance. […] Early diagnosis is critical in mesenteric ischemia and requires a mesenteric angiogram, usually by CT.

• #2 Epidemiology and Pathophysiology of Mesenteric Vascular Disease | Clinical Gate

  https://clinicalgate.com/epidemiology-and-pathophysiology-of-mesenteric-vascular-disease/

  Nonocclusive mesenteric ischemia (NOMI) accounts for 25% of all episodes of acute intestinal ischemia. […] Previous reports have identified multiple risk factors for development of NOMI. […] Mesenteric venous thrombosis is a comparatively rare form of mesenteric ischemia. […] Mesenteric venous thrombosis currently constitutes no more than 5% to 15% of all cases of acute mesenteric ischemia. […] Chronic mesenteric ischemia results from atherosclerosis in 90% of cases. […] Risk factors for atherosclerotic-associated CMI are similar to those of other atherosclerotic conditions, including a positive family history, sedentary lifestyle, hypertension, hypercholesterolemia, and smoking. […] Approximately 60% of patients with CMI are female, and nearly 50% of patients have a history of earlier cardiovascular surgery. […] The prevalence of potentially flow-limiting stenosis within the mesenteric vessels increases with age, with up to 67% of those older than 80 years of age having more than 50% stenosis in some mesenteric artery.

• #2 Acute mesenteric arterial occlusion – UpToDate

  https://www.uptodate.com/contents/acute-mesenteric-arterial-occlusion

  Acute mesenteric arterial occlusion accounts for 67 to 95 percent of cases of acute mesenteric ischemia. […] In one review, there has been a significant decrease in the percentage of embolic events since 2000. […] The two major causes of acute mesenteric arterial occlusion are mesenteric arterial embolism and mesenteric arterial thrombosis.

• #2 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.

• #2 EM@3AM: Mesenteric Ischemia – emDocs

  https://www.emdocs.net/em3am-mesenteric-ischemia/

  Epidemiology: […] 0.09% incidence annually […] Mortality within first 24 hours 60-80% […] Time is crucial in mortality […] Mortality 70% if time to diagnosis > 24 hours […] Mortality 14% if surgical intervention without 12 hours of symptom onset […] Comorbidity Prevalence: […] Peripheral Arterial Disease 27% […] Coronary Artery Disease 46% […] HTN, HLD, DM, and obesity also common […] 14%/year risk of mesenteric ischemia secondary to atrial fibrillation CITE (2.3%/year stroke risk) […] […] […] The majority of cases of acute mesenteric ischemia are the result of acute arterial occlusion resulting from embolization from the heart. Risk factors include dysrhythmias (particularly atrial fibrillation), atherosclerosis, valvular heart disease and recent myocardial infarction. The superior mesenteric artery is most frequently affected in acute arterial occlusion. This artery supplies the distal half of the duodenum to the proximal two-thirds of the transverse colon. It is likely the most commonly involved artery due to its large caliber and narrow takeoff angle from the aorta. In addition to an acute embolic event, mesenteric ischemia can be due to progression of atherosclerotic disease with arterial or venous thrombosis, or nonocclusive ischemia due to hypoperfusion or vasospasm. Patients with acute mesenteric ischemia due to arterial embolism present with sudden onset diffuse abdominal pain, vomiting and diarrhea. Early on, the pain is out of proportion to physical exam findings. As the ischemia progresses and infarct occurs, pain becomes more localized and peritoneal signs can be present. CT angiography is the imaging study of choice for diagnosis with a sensitivity and specificity of over 90%. Management includes fluid resuscitation, broad spectrum IV antibiotics and emergent surgical consultation.

• #2 Incidence, diagnosis, management and outcome of acute mesenteric ischaemia: a prospective, multicentre observational study (AMESI Study) | Critical Care | Full Text

  https://ccforum.biomedcentral.com/articles/10.1186/s13054-024-04807-4

  The aim of this multicentre prospective observational study was to identify the incidence, patient characteristics, diagnostic pathway, management and outcome of acute mesenteric ischaemia (AMI). […] AMI occurred in 0.038% of adult admissions in participating acute care hospitals worldwide. […] The overall incidence of AMI and AMI subtypes varies worldwide, and case ascertainment is challenging. […] A recent survey has identified delay in diagnosis of AMI and heterogeneity in management approaches as contributing to poor outcomes. […] The overall occurrence rate of confirmed AMI was lower than anticipated based on previous analyses. […] The distribution of different subtypes of AMI was largely similar to literature data, but the degree of diagnostic uncertainty was surprising in this prospective study.

• #2 Epidemiology of Acute Mesenteric Ischemia: A Population-Based Investigation – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36261602/

  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 identified-an 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%.

• #2 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. […] The prognosis of AMI is poor, with patients experiencing high morbidity and mortality rates. While there is a downward trend in mortality rates since the 1960s, the AMI mortality range remains high, occurring at rates between 60% and 80%. The specific AMI classification affects the likelihood of mortality, with acute embolism having a better prognosis, followed by NOMI and acute thrombosis. Factors associated with mortality include advanced age, bowel resection during second-look surgery, metabolic acidosis, renal insufficiency, and symptom duration.

• #2 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 – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/acute-mesenteric-ischemia

  Early diagnosis of mesenteric ischemia is particularly important because mortality increases significantly once intestinal infarction has occurred. […] Mesenteric ischemia must be considered in any patient 50 with known risk factors or predisposing conditions who develops sudden, severe abdominal pain. […] If diagnosis and treatment take place before infarction occurs, mortality is low; after intestinal infarction, mortality is high and varies depending on the etiology. […] For this reason, clinical diagnosis of mesenteric ischemia should supersede diagnostic tests, which may delay treatment. […] Early diagnosis is critical because mortality increases significantly once intestinal infarction has occurred.

• #2 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 key to early diagnosis is a high level of clinical suspicion. […] The classic presentation of AMI, i.e., severe, poorly localized abdominal pain that is out of proportion to the physical examination, is becoming less common, while the acute on chronic presentations of mesenteric ischemia are more typical, and probably underdiagnosed. […] Recent published evidence suggests that treatment of occlusive AMI in intestine stroke centers using a multidisciplinary approach improves outcomes. […] The management of patients with AMI is summarized in Fig. 1.

• #2

  https://link.springer.com/article/10.1007/s00134-024-07363-1

  Acute mesenteric ischaemia (AMI) is diagnosed in 0.040.07% of adult hospital admissions, with a highly variable proportion (050%) of non-occlusive mesenteric ischaemia (NOMI) observed in different hospitals. […] The variable incidence most likely indicates differences in awareness. […] Mortality of AMI is globally still very high, with approximately 50% survival. […] Mortality is highest for NOMI and lowest for mesenteric venous thrombosis. […] It is believed that accurate serum/plasma biomarkers for early diagnosis of AMI are necessary to substantially improve outcomes.

• #2 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.

• #2 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. […] Recent reviews have shown significant declines in the in-hospital mortality rate among patients treated for acute mesenteric ischemia; however they remain high at 17%21% among patients requiring revascularization. […] Delays in diagnosis and treatment remain the greatest challenge to reducing morbidity and mortality for all forms of mesenteric ischemia.

• #2 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.

• #2 Mesenteric ischemia epidemiology and demographics – wikidoc

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

  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.

• #3 Delayed Diagnosis of Mesenteric Ischemia | PSNet

  https://psnet.ahrq.gov/web-mm/delayed-diagnosis-mesenteric-ischemia

  Mesenteric ischemia occurs when there is reduced blood flow to the small or large intestines from multiple potential etiologies involving interruptions of either the arterial or venous systems. […] The frequency of these major causes of mesenteric ischemia among all patients is estimated as: 50% mesenteric arterial embolism, 15-25% mesenteric arterial thrombosis, 5% mesenteric venous thrombosis, and 20-30% nonocclusive mesenteric ischemia. […] Given the potential for devastating outcomes when not diagnosed in a timely fashion, as in the presented case, mesenteric ischemia is an important diagnosis to consider in all patients with severe abdominal pain. […] Its chronic form most commonly affects women; more than 70% of patients with this disease are female. […] In patients with acute abdominal pain, it is important to assess for atherosclerotic risk factors and arrythmias, potential sources of embolus, and/or hypoperfusion, as this would increase clinical suspicion for this disorder. […] In the setting of chronic mesenteric ischemia, abdominal duplex ultrasound of the mesenteric vasculature can be used for monitoring and surveillance. […] Early diagnosis is critical in mesenteric ischemia and requires a mesenteric angiogram, usually by CT.

• #3 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.

• #3 Epidemiology and Pathophysiology of Mesenteric Vascular Disease | Clinical Gate

  https://clinicalgate.com/epidemiology-and-pathophysiology-of-mesenteric-vascular-disease/

  Nonocclusive mesenteric ischemia (NOMI) accounts for 25% of all episodes of acute intestinal ischemia. […] Previous reports have identified multiple risk factors for development of NOMI. […] Mesenteric venous thrombosis is a comparatively rare form of mesenteric ischemia. […] Mesenteric venous thrombosis currently constitutes no more than 5% to 15% of all cases of acute mesenteric ischemia. […] Chronic mesenteric ischemia results from atherosclerosis in 90% of cases. […] Risk factors for atherosclerotic-associated CMI are similar to those of other atherosclerotic conditions, including a positive family history, sedentary lifestyle, hypertension, hypercholesterolemia, and smoking. […] Approximately 60% of patients with CMI are female, and nearly 50% of patients have a history of earlier cardiovascular surgery. […] The prevalence of potentially flow-limiting stenosis within the mesenteric vessels increases with age, with up to 67% of those older than 80 years of age having more than 50% stenosis in some mesenteric artery.

• #3 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.

• #3 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 […] Most commonly (95%) caused by transient hypoperfusion due to nonocclusive disease […] Older patients with risk factors for atherosclerosis are at especially high risk for developing colon ischemia […] Severe abdominal pain and bloody diarrhea after an abdominal aortic aneurysm repair is a classic manifestation of colon ischemia […] Most commonly occurs in individuals 60 years of age […] Prevalence in patients with acute abdomen: 1% […] Mortality: 50-70% […] CMI most commonly occurs in adults 60 years of age […] MAOD is common, while CMI is rare […] 5-year mortality for untreated CMI is close to 100% […] Symptoms are relieved in 95% of patients following revascularization.

• #3

  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.

• #3 Epidemiology of Acute Mesenteric Ischemia: A Population-Based Investigation – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36261602/

  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 identified-an 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%.

• #3 EM@3AM: Mesenteric Ischemia – emDocs

  https://www.emdocs.net/em3am-mesenteric-ischemia/

  Epidemiology: […] 0.09% incidence annually […] Mortality within first 24 hours 60-80% […] Time is crucial in mortality […] Mortality 70% if time to diagnosis > 24 hours […] Mortality 14% if surgical intervention without 12 hours of symptom onset […] Comorbidity Prevalence: […] Peripheral Arterial Disease 27% […] Coronary Artery Disease 46% […] HTN, HLD, DM, and obesity also common […] 14%/year risk of mesenteric ischemia secondary to atrial fibrillation CITE (2.3%/year stroke risk) […] […] […] The majority of cases of acute mesenteric ischemia are the result of acute arterial occlusion resulting from embolization from the heart. Risk factors include dysrhythmias (particularly atrial fibrillation), atherosclerosis, valvular heart disease and recent myocardial infarction. The superior mesenteric artery is most frequently affected in acute arterial occlusion. This artery supplies the distal half of the duodenum to the proximal two-thirds of the transverse colon. It is likely the most commonly involved artery due to its large caliber and narrow takeoff angle from the aorta. In addition to an acute embolic event, mesenteric ischemia can be due to progression of atherosclerotic disease with arterial or venous thrombosis, or nonocclusive ischemia due to hypoperfusion or vasospasm. Patients with acute mesenteric ischemia due to arterial embolism present with sudden onset diffuse abdominal pain, vomiting and diarrhea. Early on, the pain is out of proportion to physical exam findings. As the ischemia progresses and infarct occurs, pain becomes more localized and peritoneal signs can be present. CT angiography is the imaging study of choice for diagnosis with a sensitivity and specificity of over 90%. Management includes fluid resuscitation, broad spectrum IV antibiotics and emergent surgical consultation.

• #3 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. […] The prognosis of AMI is poor, with patients experiencing high morbidity and mortality rates. While there is a downward trend in mortality rates since the 1960s, the AMI mortality range remains high, occurring at rates between 60% and 80%. The specific AMI classification affects the likelihood of mortality, with acute embolism having a better prognosis, followed by NOMI and acute thrombosis. Factors associated with mortality include advanced age, bowel resection during second-look surgery, metabolic acidosis, renal insufficiency, and symptom duration.

• #3 Acute Mesenteric Ischemia – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/acute-mesenteric-ischemia

  Early diagnosis of mesenteric ischemia is particularly important because mortality increases significantly once intestinal infarction has occurred. […] Mesenteric ischemia must be considered in any patient 50 with known risk factors or predisposing conditions who develops sudden, severe abdominal pain. […] If diagnosis and treatment take place before infarction occurs, mortality is low; after intestinal infarction, mortality is high and varies depending on the etiology. […] For this reason, clinical diagnosis of mesenteric ischemia should supersede diagnostic tests, which may delay treatment. […] Early diagnosis is critical because mortality increases significantly once intestinal infarction has occurred.

• #3 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. […] Recent reviews have shown significant declines in the in-hospital mortality rate among patients treated for acute mesenteric ischemia; however they remain high at 17%21% among patients requiring revascularization. […] Delays in diagnosis and treatment remain the greatest challenge to reducing morbidity and mortality for all forms of mesenteric ischemia.

• #4 Delayed Diagnosis of Mesenteric Ischemia | PSNet

  https://psnet.ahrq.gov/web-mm/delayed-diagnosis-mesenteric-ischemia

  Mesenteric ischemia occurs when there is reduced blood flow to the small or large intestines from multiple potential etiologies involving interruptions of either the arterial or venous systems. […] The frequency of these major causes of mesenteric ischemia among all patients is estimated as: 50% mesenteric arterial embolism, 15-25% mesenteric arterial thrombosis, 5% mesenteric venous thrombosis, and 20-30% nonocclusive mesenteric ischemia. […] Given the potential for devastating outcomes when not diagnosed in a timely fashion, as in the presented case, mesenteric ischemia is an important diagnosis to consider in all patients with severe abdominal pain. […] Its chronic form most commonly affects women; more than 70% of patients with this disease are female. […] In patients with acute abdominal pain, it is important to assess for atherosclerotic risk factors and arrythmias, potential sources of embolus, and/or hypoperfusion, as this would increase clinical suspicion for this disorder. […] In the setting of chronic mesenteric ischemia, abdominal duplex ultrasound of the mesenteric vasculature can be used for monitoring and surveillance. […] Early diagnosis is critical in mesenteric ischemia and requires a mesenteric angiogram, usually by CT.

• #4 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.

• #4 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 […] Most commonly (95%) caused by transient hypoperfusion due to nonocclusive disease […] Older patients with risk factors for atherosclerosis are at especially high risk for developing colon ischemia […] Severe abdominal pain and bloody diarrhea after an abdominal aortic aneurysm repair is a classic manifestation of colon ischemia […] Most commonly occurs in individuals 60 years of age […] Prevalence in patients with acute abdomen: 1% […] Mortality: 50-70% […] CMI most commonly occurs in adults 60 years of age […] MAOD is common, while CMI is rare […] 5-year mortality for untreated CMI is close to 100% […] Symptoms are relieved in 95% of patients following revascularization.

• #4 Acute Mesenteric Ischemia – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/acute-mesenteric-ischemia

  Early diagnosis of mesenteric ischemia is particularly important because mortality increases significantly once intestinal infarction has occurred. […] Mesenteric ischemia must be considered in any patient 50 with known risk factors or predisposing conditions who develops sudden, severe abdominal pain. […] If diagnosis and treatment take place before infarction occurs, mortality is low; after intestinal infarction, mortality is high and varies depending on the etiology. […] For this reason, clinical diagnosis of mesenteric ischemia should supersede diagnostic tests, which may delay treatment. […] Early diagnosis is critical because mortality increases significantly once intestinal infarction has occurred.

• #5 Delayed Diagnosis of Mesenteric Ischemia | PSNet

  https://psnet.ahrq.gov/web-mm/delayed-diagnosis-mesenteric-ischemia

  Mesenteric ischemia occurs when there is reduced blood flow to the small or large intestines from multiple potential etiologies involving interruptions of either the arterial or venous systems. […] The frequency of these major causes of mesenteric ischemia among all patients is estimated as: 50% mesenteric arterial embolism, 15-25% mesenteric arterial thrombosis, 5% mesenteric venous thrombosis, and 20-30% nonocclusive mesenteric ischemia. […] Given the potential for devastating outcomes when not diagnosed in a timely fashion, as in the presented case, mesenteric ischemia is an important diagnosis to consider in all patients with severe abdominal pain. […] Its chronic form most commonly affects women; more than 70% of patients with this disease are female. […] In patients with acute abdominal pain, it is important to assess for atherosclerotic risk factors and arrythmias, potential sources of embolus, and/or hypoperfusion, as this would increase clinical suspicion for this disorder. […] In the setting of chronic mesenteric ischemia, abdominal duplex ultrasound of the mesenteric vasculature can be used for monitoring and surveillance. […] Early diagnosis is critical in mesenteric ischemia and requires a mesenteric angiogram, usually by CT.

• #6 Delayed Diagnosis of Mesenteric Ischemia | PSNet

  https://psnet.ahrq.gov/web-mm/delayed-diagnosis-mesenteric-ischemia

  Mesenteric ischemia occurs when there is reduced blood flow to the small or large intestines from multiple potential etiologies involving interruptions of either the arterial or venous systems. […] The frequency of these major causes of mesenteric ischemia among all patients is estimated as: 50% mesenteric arterial embolism, 15-25% mesenteric arterial thrombosis, 5% mesenteric venous thrombosis, and 20-30% nonocclusive mesenteric ischemia. […] Given the potential for devastating outcomes when not diagnosed in a timely fashion, as in the presented case, mesenteric ischemia is an important diagnosis to consider in all patients with severe abdominal pain. […] Its chronic form most commonly affects women; more than 70% of patients with this disease are female. […] In patients with acute abdominal pain, it is important to assess for atherosclerotic risk factors and arrythmias, potential sources of embolus, and/or hypoperfusion, as this would increase clinical suspicion for this disorder. […] In the setting of chronic mesenteric ischemia, abdominal duplex ultrasound of the mesenteric vasculature can be used for monitoring and surveillance. […] Early diagnosis is critical in mesenteric ischemia and requires a mesenteric angiogram, usually by CT.

• #7 Delayed Diagnosis of Mesenteric Ischemia | PSNet

  https://psnet.ahrq.gov/web-mm/delayed-diagnosis-mesenteric-ischemia

  Mesenteric ischemia occurs when there is reduced blood flow to the small or large intestines from multiple potential etiologies involving interruptions of either the arterial or venous systems. […] The frequency of these major causes of mesenteric ischemia among all patients is estimated as: 50% mesenteric arterial embolism, 15-25% mesenteric arterial thrombosis, 5% mesenteric venous thrombosis, and 20-30% nonocclusive mesenteric ischemia. […] Given the potential for devastating outcomes when not diagnosed in a timely fashion, as in the presented case, mesenteric ischemia is an important diagnosis to consider in all patients with severe abdominal pain. […] Its chronic form most commonly affects women; more than 70% of patients with this disease are female. […] In patients with acute abdominal pain, it is important to assess for atherosclerotic risk factors and arrythmias, potential sources of embolus, and/or hypoperfusion, as this would increase clinical suspicion for this disorder. […] In the setting of chronic mesenteric ischemia, abdominal duplex ultrasound of the mesenteric vasculature can be used for monitoring and surveillance. […] Early diagnosis is critical in mesenteric ischemia and requires a mesenteric angiogram, usually by CT.

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