Digestive Surgery

Research Article

Acute Mesenteric Infarction: The Chameleon of Acute Abdomen Evaluating the Quality of the Diagnostic Parameters in Acute Mesenteric Ischemia

Grotelueschen R. · Miller V. · Heidelmann L.M. · Melling N. · Ghadban T. · Grupp K. · Reeh M. · Welte M.-N. · Uzunoglu F.G. · Izbicki J.R. · Bachmann K.A.

Author affiliations

Department of General, Visceral and Thoracic Surgery, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany

Keywords: Acute abdomenMesenteric infarctionMesenteric ischemiaDiagnostic parameter

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Dig Surg 2021;38:149–157
https://doi.org/10.1159/000512779

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Article / Publication Details

First-Page Preview
Abstract of Research Article

Received: March 23, 2020
Accepted: October 25, 2020
Published online: January 27, 2021
Issue release date: March 2021

Number of Print Pages: 9
Number of Figures: 0
Number of Tables: 4

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: https://www.karger.com/DSU

Abstract

Introduction/Objective: Acute mesenteric ischemia (AMI) is difficult to diagnose. Since the established parameters have low sensitivity and specificity, the aim of this study is to analyze the diagnostic quality of the established parameters of AMI. Methods: All patients that underwent emergency surgery due to suspected diagnosis of mesenteric ischemia at the University Medical Center Hamburg-Eppendorf between 2008 and 2014 were evaluated. Overall, 275 patients were enrolled and pre-, intra- and postoperative data were evaluated. Results: In 200 patients, a mesenteric ischemia was confirmed intraoperatively, and 75 patients had no ischemia. Comparing these groups, the rate of patients with pH < 7.2 (25 vs. 12%; p = 0.021) and elevated mean CRP level (175 ± 117 mg/L vs. 139 ± 104 mg/L; p = 0.019) was significantly higher in ischemic patients. There was no significant difference in the level of preoperative lactate. Concerning abdominal CT scan, a sensitivity and specificity of 61 and 68%, respectively, was found. Conclusion: New diagnostic parameters are needed. So far, explorative laparotomy is the only reliable diagnostic method to detect mesenteric infarction.

© 2021 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Research Article

Received: March 23, 2020
Accepted: October 25, 2020
Published online: January 27, 2021
Issue release date: March 2021

Number of Print Pages: 9
Number of Figures: 0
Number of Tables: 4

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: https://www.karger.com/DSU

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