NONOCCLUSIVE MESENTERIC ISCHEMIA REMAINS A DIAGNOSTIC DILEMMA

Citation
Tj. Howard et al., NONOCCLUSIVE MESENTERIC ISCHEMIA REMAINS A DIAGNOSTIC DILEMMA, The American journal of surgery, 171(4), 1996, pp. 405-408
Citations number
20
Categorie Soggetti
Surgery
ISSN journal
00029610
Volume
171
Issue
4
Year of publication
1996
Pages
405 - 408
Database
ISI
SICI code
0002-9610(1996)171:4<405:NMIRAD>2.0.ZU;2-F
Abstract
BACKGROUND: Despite reports of low mortality and high bowel-salvage ra tes in nonocclusive mesenteric ischemia (NOMI), our experience has bee n much less favorable. This study analyzes our experience with NOMI. P ATIENTS AND METHODS: A retrospective chart review (1979 to 1992) ident ified 113 patients with acute mesenteric ischemia, of whom 13 (12%) me t our criteria for NOMI. RESULTS: Patients were grouped into early and late presenters. The 5 early presenters were women, younger (mean age [+/- SD] 50 +/- 5.8 years.), with no risk factors, and had vague symp toms leading to a delay in diagnosis. The 7 late presenters were older (mean age [+/- SD] 63 +/- 5.3 years), with identifiable risk factors; all had bowel infarction at the time of initial diagnosis. CONCLUSION S: Vague symptoms and a wide range of patients at risk make early diag nosis of NOMI uncommon. In the absence of early diagnosis, bowel resec tion with its high morbidity and mortality remains the only applicable treatment option in the vast majority of patients.