Acute mesenteric ischemia: experience in the treatment of patients at a multidisciplinary hospital

Acute mesenteric ischemia is a group of conditions characterized by an acute impairment of intestinal blood supply, resulting in critical ischemia and necrosis of the affected bowel segments.

Purpose of the study. To analyze the diagnostic and treatment outcomes of patients with acute mesenteric ischemia in a multidisciplinary hospital and to evaluate the outcomes of surgical treatment strategies incorporating endovascular techniques.

Patients and methods. A retrospective analysis was performed of the diagnostic and treatment outcomes of 73 patients admitted to a multidisciplinary hospital between 2021 and 2023. The study included 50 (68.49 %) women and 23 (31.51 %) men. The mean age of the patients was 75.3 ± 9.05 years. The time from the onset of the first symptoms to transport by ambulance and hospital admission was up to 6 h in 23 patients (31.5 %), 6–24 h in 20 patients (27.4 %), and more than 24 h in 30 patients (41.1 %). Depending on the diagnostic and treatment strategy used, the patients were divided into five groups.

 Results. The overall mortality rate in the study cohort was 69.86 %. Mortality rates varied according to the diagnostic and treatment strategy. The lowest mortality rate was observed in the group receiving endovascular treatment alone (44.4 %). Mortality was 54.55 % in the group undergoing combined endovascular and open surgical treatment, 71.4 % in the group undergoing surgical treatment alone, 100 % in the group undergoing combined open vascular and surgical interventions, and 100 % in the group receiving conservative treatment.

Conclusion. Rapid transport of patients with acute mesenteric ischemia to a multidisciplinary hospital and timely CT angiography improve diagnostic accuracy, shorten the time to diagnosis, facilitate the selection of an appropriate treatment strategy, and reduce the risk of adverse outcomes. The use of endovascular techniques to restore mesenteric vessel patency as part of the comprehensive treatment of acute mesenteric ischemia reduces mortality.

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