Review: Acute superior mesenteric artery embolism: A vascular emergency cannot be ignored by physicians

Guanyi Liao, Siyang Chen, Haoyang Cao, Wuwan Wang, Qing Gao, Leonidas G. Koniaris

Research output: Contribution to journalArticle

2 Scopus citations

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.

Original languageEnglish (US)
Article numbere14446
JournalMedicine (United States)
Volume98
Issue number6
DOIs
StatePublished - Feb 1 2019

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Keywords

  • acute mesenteric ischemia
  • diagnostic approach
  • therapeutic management

ASJC Scopus subject areas

  • Medicine(all)

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