İstanbul Medical Journal (May 2020)

Evaluation of Factors Affecting the Mortality and Morbidity of Patients with Acute Mesenteric Ischaemia

  • Ali Emre Naycı,
  • Coşkun Çakır

DOI
https://doi.org/10.4274/imj.galenos.2020.68585
Journal volume & issue
Vol. 21, no. 3
pp. 213 – 217

Abstract

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Introduction:Acute mesenteric ischaemia (AMI) is a disease with high mortality that is not easy to diagnose. It usually develops as a result of arterial obstructions of mesenteric vessels. In this study, we aimed to evaluate the laboratory and clinical results of patients operated for AMI.Methods:Our study included 44 patients diagnosed with AMI between January 2014 and January 2017. From our hospital records, we included patients’ demographic data, comorbid diseases, hospital admission time, blood leucocyte, platelet, amylase, lactate, Ph, bicarbonate and lactate dehydrogenase values, preoperative abdominal computed tomography results, surgery duration, postoperative period according to the clinical course of the patients at the postoperative 48th hour and the need for a second look and additional resection and the clinical follow-up.Results:The patients’ female/male ratio was 6/5, and the mean age was 69.4±12.0 years. Thirty-two (72.7%) patients developed occlusion of the superior mesenteric artery due to thrombosis or embolism. Twenty-eight (63.6%) patients underwent a second-look operation after 48 h, and 15 of them required additional resection. The mortality rate was significantly higher in patients with hospital admission and operation time of 12 h or more. Lactate levels were significantly higher in the patient group with a higher mortality rate. Postoperative leucocyte value was significantly increased in the postoperative period of the first operation compared with that in the preoperative period in patients with additional resection.Conclusion:AMI should be kept in mind in elderly patients with comorbid diseases who present to the emergency department with abdominal pain, and these patients should be approached with suspicion. High leucocyte and lactate levels may support the clinician’s diagnostic opinion about AMI. In addition, the increase in leucocyte values in the postoperative period supports the ischaemia progression and the need for a second look.

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