Acute Mesenteric Ischemia: Still High Mortality Rate in the Era of 24-Hour Availability of Angiography
Bunthoon Nonthasoot MD*, Thawatchai Tullavardhana MD*, Boonchoo Sirichindakul MD*, Jade Suphapol MD*, Supanit Nivatvongs MD*
Affiliation : * Department of Surgery, Faculty of Medicine, Chulalongkorn University, Thailand
Backgrounds: Acute mesenteric ischemia (AMI) is a serious condition with high mortality rate due to difficult
and late diagnosis. Early and aggressive evaluation in high risk patients by mesenteric angiography is the
key to the reduction in mortality rate. However, many physicians hesitated to perform it because of its avail-
ability, the risk of complications and high negative results. This study reviewed outcome of AMI in term of
mortality rate, factors associated with mortality and the rate of angiography in high risk patients.
Materials and Methods : The clinical data of the patients who were diagnosed as AMI were retrospectively
reviewed. The clinical outcome was recorded and the factors associated with mortality were analysed.
Results : Thirty-five patients were enrolled into this study during 5 years. The mortality rate was 74.3%. There
were 22 high risk patients for AMI. The rate of angiography performed in this group was 4.5% (1/22). The
factors associated with mortality were age more than 60 years, patients with peritonitis, hypotension, arterial
cause, time interval between admission and operation or treatment more than 24 hours, bowel gangrene >
100 cms. However all these factors were not statistically significant.
Conclusion : The mortality rate of AMI is still high even at the tertiary hospital where the angiography is
available 24 hours. To decrease the mortality rate, the physicians must have the high index of suspicion in
high risk patients and do not hesitate to perform early mesenteric angiography.
Keywords : Acute mesenteric ischemia, Mesenteric angiography
