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Invited Critique: Management of Acute Mesenteric Ischemia

Invited Critique: Management of Acute Mesenteric Ischemia Invited Critique espite better insights into the pathophysiology of acute mesenteric ischemia, these syndromes remain highly mor- bid events with reported mortality rates exceeding 60%. The increase in the incidence of these disorders (0.1% of D hospital admissions) is secondary to multiple factors, such as heightened awareness for the diagnosis, the advanced mean age of the population, and the increasing number of critically ill patients. Acknowledged risk factors for acute mesenteric ischemia include cardiac arrhythmias, advanced age, low cardiac output states, generalized atherosclerosis, congestive heart failure, severe valvular cardiac disease, recent myocardial infarction, and intra-abdominal malignancy. Mansour’s concise review addresses the proper diagnostic and operative approach to these lethal syndromes. Early and precise diagnosis is key to survival since once bowel infarction has occurred, outcomes are invariably compromised. To my knowledge, limited information exists regarding the long-term outlook for patients who survive an episode of intestinal ischemia. In a comprehensive report by Klempnauer et al of 90 patients suffering from intestinal ischemia, 31 patients survived and were discharged from the hospital. The cumulative 5-year survival rate was about 50% (16 of 31 pa- tients); the mortality was greatest during the first year after the incident. The worst survival rate http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Invited Critique: Management of Acute Mesenteric Ischemia

JAMA Surgery , Volume 134 (3) – Mar 1, 1999

Invited Critique: Management of Acute Mesenteric Ischemia

Abstract

Invited Critique espite better insights into the pathophysiology of acute mesenteric ischemia, these syndromes remain highly mor- bid events with reported mortality rates exceeding 60%. The increase in the incidence of these disorders (0.1% of D hospital admissions) is secondary to multiple factors, such as heightened awareness for the diagnosis, the advanced mean age of the population, and the increasing number of critically ill patients. Acknowledged risk factors for acute mesenteric...
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Publisher
American Medical Association
Copyright
Copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6254
eISSN
2168-6262
DOI
10.1001/archsurg.134.3.331
Publisher site
See Article on Publisher Site

Abstract

Invited Critique espite better insights into the pathophysiology of acute mesenteric ischemia, these syndromes remain highly mor- bid events with reported mortality rates exceeding 60%. The increase in the incidence of these disorders (0.1% of D hospital admissions) is secondary to multiple factors, such as heightened awareness for the diagnosis, the advanced mean age of the population, and the increasing number of critically ill patients. Acknowledged risk factors for acute mesenteric ischemia include cardiac arrhythmias, advanced age, low cardiac output states, generalized atherosclerosis, congestive heart failure, severe valvular cardiac disease, recent myocardial infarction, and intra-abdominal malignancy. Mansour’s concise review addresses the proper diagnostic and operative approach to these lethal syndromes. Early and precise diagnosis is key to survival since once bowel infarction has occurred, outcomes are invariably compromised. To my knowledge, limited information exists regarding the long-term outlook for patients who survive an episode of intestinal ischemia. In a comprehensive report by Klempnauer et al of 90 patients suffering from intestinal ischemia, 31 patients survived and were discharged from the hospital. The cumulative 5-year survival rate was about 50% (16 of 31 pa- tients); the mortality was greatest during the first year after the incident. The worst survival rate

Journal

JAMA SurgeryAmerican Medical Association

Published: Mar 1, 1999

References