Acute Mesenteric Ischemia Management Strategies
Summary
Acute mesenteric ischaemia (AMI) represents a sudden interruption of arterial or venous blood flow to the small intestine, precipitating tissue hypoxia, inflammation and, if untreated, transmural necrosis with high mortality. Prompt recognition hinges on awareness of risk factors—such as atrial fibrillation, peripheral vascular disease and vasopressor use—and integration of clinical, laboratory and imaging findings. Modern management balances rapid diagnosis with timely intervention: contrast-enhanced computed tomography angiography (CTA) establishes vessel patency and guides strategy; endovascular revascularisation via catheter-based techniques offers a less invasive alternative to open surgery in selected cases; and damage-control surgery with planned second-look laparotomy permits assessment of bowel viability. A multidisciplinary pathway linking emergency physicians, interventional radiologists, surgeons and intensive care specialists is essential to reduce delays, limit intestinal loss and improve global outcomes.
Research from Nature Portfolio
A comprehensive meta-analysis of intestinal fatty-acid-binding protein (I-FABP) examined its diagnostic performance across nine studies comprising over 1 200 patients. The pooled sensitivity was 0.80 and specificity 0.85, with an area under the receiver-operating characteristic curve of 0.86. These results underscore the potential of I-FABP as a confirmatory biomarker of enterocyte injury but highlight substantial heterogeneity in sampling times and patient selection. The analysis calls for well-designed prospective trials to define optimal cut-offs, assess serial measurements and evaluate combinations of biomarkers to enhance early detection of AMI.
Acute Mesenteric Ischemia Management Strategies publication trend
The graph below shows the total number of articles in acute mesenteric ischemia management strategies across all publications each year (not limited to Nature Index journals).
Technical terms
Acute mesenteric ischaemia (AMI): Sudden loss of blood supply to the intestine, leading to cellular hypoxia and potential necrosis.
Revascularisation: Restoration of blood flow to ischaemic tissue, accomplished either surgically or via endovascular techniques.
Endovascular therapy: Minimally invasive procedures performed within the vascular lumen to reopen occluded arteries.
Intestinal fatty-acid-binding protein (I-FABP): A cytosolic protein released into circulation upon enterocyte injury, serving as a biomarker of intestinal ischaemia.
Computed tomography angiography (CTA): Contrast-enhanced imaging method that visualises mesenteric vessels and assesses perfusion in suspected AMI.
References
- Incidence, diagnosis, management and outcome of acute mesenteric ischaemia: a prospective, multicentre observational study (AMESI Study). Critical Care (2024).
- Diagnostic accuracy of biomarkers to detect acute mesenteric ischaemia in adult patients: a systematic review and meta-analysis. World Journal of Emergency Surgery (2023).
- Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. World Journal of Emergency Surgery (2022).
- Accuracy of the serum intestinal fatty-acid-binding protein for diagnosis of acute intestinal ischemia: a meta-analysis. Scientific Reports (2016).
About these summaries
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