Mesenteric ischemia from occlusive disease of the mesenteric vessels is a relatively uncommon problem but may have catastrophic consequences if not immediately recognized and treated. Most cases appear in the elderly, although any age patient may be affected. Patients with ischemic bowel may present with “pain out of proportion to physical findings.” Although presentation may vary based on the exact etiology of the condition, the degree and acuity of ischemia, and other concurrent medical conditions, it must be stressed that classic clinical manifestations of intestinal ischemia (fever, leukocytosis, peritonitis, and acidosis) are the result of systemic signs of bowel necrosis and as such signify advanced disease. Regardless of the exact cause of mesenteric insufficiency, ischemic bowel must be identified earlier rather than later, as failure to recognize and treat this condition in its early stages decreases the chance for bowel salvage and adversely affects survival. Management in an intensive care setting is mandated in the patient suspected of having mesenteric ischemia.
KeywordsSuperior Mesenteric Artery Mesenteric Ischemia Ischemic Bowel Intensive Care Setting Acute Mesenteric Ischemia
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