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.