Medicina v Kuzbasse (Jun 2018)
ACUTE MESENTERIC ISCHEMIA: APPROACHES TO DIAGNOSIS AND SURGICAL TREATMENT
Abstract
Acute mesenteric ischemia is a potentially dangerous vascular pathology with a total mortality of 60-80 % and its constant increase by 1-5 % per year. Acute mesenteric ischemia is included in the group of pathophysiologic processes that lead to necrosis of the intestine. The main reason for low survival is the difficulty in diagnosing this condition. The manifestations of the disease in most cases are non-specific, often there is a discrepancy between severe abdominal pain and minimal clinical manifestations; Physical examination does not allow to reliably distinguish between ischemia and intestinal infarction; complications such as ileus, peritonitis, pancreatate and gastrointestinal bleeding, can mask the initial signs and symptoms of the disease. Risk factors and clinical picture differ depending on the main pathological mechanism of the disease development. As acute intestinal ischemia rapidly progresses to irreversible necrosis, serious metabolic disorders occur leading to multiple organ dysfunction and death. Timely use of diagnostic and surgical methods for rapid restoration of blood flow is the key to reducing the high mortality associated with complications of acute mesenteric ischemia.