Current approaches to diagnosis and management of Acute Mesenteric Ischaemia - a scoping review.

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery Pub Date : 2025-07-15 DOI:10.1159/000547297

Liam Costello, William P Duggan, Michael Flanagan, Conor Toale, Dara O Kavanagh

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引用次数: 0

Abstract

Introduction: Acute mesenteric ischaemia (AMI) is a life-threatening condition with mortality exceeding 50%. This scoping review evaluates current diagnostic and management strategies, comparing endovascular and open surgical approaches.

Methods: Following Arksey and O'Malley's framework, a systematic search was conducted in OVID MEDLINE, EMBASE, and Web of Science (2005-2024). English-language studies on AMI were included. Data on diagnostic methods, mortality, hospital/ICU stay, and surgical outcomes were extracted.

Results: Thirty-nine studies (20,991 patients) were analysed. CT was the primary diagnostic tool, with diagnosis delays ranging from 13.9-48 hours. Endovascular interventions demonstrated lower 30-day mortality (0%-53.8%) versus open surgery (21%-81%). Hospital (5-15.35 vs. 5.7-27.26 days) and ICU stays (0-5.35 vs. 2-13 days) were shorter with endovascular management. Bowel resection and re-laparotomy rates were also reduced.

Conclusion: Endovascular management is associated with improved outcomes, including reduced mortality and shorter hospital stays. Timely diagnosis and patient selection remain critical. A multidisciplinary approach is essential, though further prospective studies are needed to standardise protocols.

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急性肠系膜缺血的当前诊断和治疗方法-范围综述。

简介：急性肠系膜缺血（AMI）是一种危及生命的疾病，死亡率超过50%。本综述评估了当前的诊断和治疗策略，比较了血管内和开放手术入路。方法：按照Arksey和O'Malley的框架，系统检索OVID MEDLINE、EMBASE和Web of Science（2005-2024）数据库。纳入了关于AMI的英语研究。提取有关诊断方法、死亡率、住院/ICU时间和手术结果的数据。结果：分析了39项研究（20,991例患者）。CT是主要的诊断工具，诊断延迟时间为13.9-48小时。与开放手术（21%-81%）相比，血管内干预显示出更低的30天死亡率（0%-53.8%）。采用血管内管理的住院时间（5-15.35天vs. 5.7-27.26天）和ICU住院时间（0-5.35天vs. 2-13天）较短。肠切除术和再次剖腹手术的发生率也有所降低。结论：血管内管理与改善预后相关，包括降低死亡率和缩短住院时间。及时诊断和患者选择仍然至关重要。多学科方法是必要的，尽管需要进一步的前瞻性研究来标准化方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.