Review: Acute superior mesenteric artery embolism

Abstract

Background: Acute mesenteric ischemia (AMI) is a life-threatening medical condition that occurs when a sudden decreased perfusion to the intestines which leads to bowel infarction, and acute superior mesenteric artery embolism (ASMAE) is the main cause of AMI. Unfortunately, with the improvement of diagnosis and treatment technology, the mortality remains high due to less frequent clinical suspicion resulted from the unclear clinical manifestation and non-specific laboratory findings. Methods: Relevant studies published were identified by searching the PubMed, Embase and Cochrane Library databases. This review presented the literatures to introduce the research progress of ASMAE in recent years. Results: Patients with the history of atrial fibrillation, heart valve disease and atherosclerosis should be considered as ASMAE. Laboratory findings are insensitive and unspecific, however, angiography and Computed tomography angiography (CTA) can provide a clear diagnosis sensitively and specifically. Endovascular approaches have been increasingly reported in multiple case series. The key to successful treatment of AMI involves early clinical recognition and early intervention to move the embolus, which can reduce the rate of misdiagnosis and save the precious time and lives of patients. Conclusions: Loss of time eventually leads to progression of ischemia to transmural bowel necrosis with peritonitis and septicemia, which may further worsen patients’ outcomes. It is important for physicians to make a timely and accurate diagnosis, which can save precious time and reduce the mortality.

Predictive and Prognostic Value of L-lactate, D-dimer, Leukocyte, C-Reactive Protein and Neutrophil/Lymphocyte Ratio in Patients with Acute Mesenteric Ischemia

“…[1,11] Heart diseases, such as AF, gastric-emptying disorder and Bergan Triad presenting with incompatible symp-toms, may not always occur. [15] Embolism is usually located 6 to 8 cm distal to the origin of the SMA, beyond the middle colic artery outlet and thus, the proximal jejunum and colon are protected. [1,15] If the diagnosis and treatment can be performed within the first 24 hours, the survival rate is 89.4%; however, if the diagnosis is delayed, this rate decreases to 27.1%.…”

“…[15] Embolism is usually located 6 to 8 cm distal to the origin of the SMA, beyond the middle colic artery outlet and thus, the proximal jejunum and colon are protected. [1,15] If the diagnosis and treatment can be performed within the first 24 hours, the survival rate is 89.4%; however, if the diagnosis is delayed, this rate decreases to 27.1%. [15] Diagnosis is made using CTA.…”

“…[1,15] If the diagnosis and treatment can be performed within the first 24 hours, the survival rate is 89.4%; however, if the diagnosis is delayed, this rate decreases to 27.1%. [15] Diagnosis is made using CTA. [16] Laboratory findings are insufficient for diagnosis.…”

“…[16] Laboratory findings are insufficient for diagnosis. [15,16] Open embolectomy and laparotomy are performed in its treatment. [15,17] In the present study, 31.8% of the patients had EAMI, the ratio of male patients to female patients was equal and the age at which the disease is seen most was 71.4 years.…”

“…[15,16] Open embolectomy and laparotomy are performed in its treatment. [15,17] In the present study, 31.8% of the patients had EAMI, the ratio of male patients to female patients was equal and the age at which the disease is seen most was 71.4 years. According to other types, patients with the highest mean age and BMI were in the EAMI group.…”