Clinical Features and Outcomes of Patients with Acute Mesenteric Ischaemia in a Retrospective Study

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Clinical Features and Outcomes of Patients with Acute Mesenteric Ischaemia in a Retrospective Study

Giuseppe Evola, Marco Vacante, Francesco Roberto Evola, Martina Barchitta, Grazia Maugeri, Giuseppe Musumeci, Velia D'Agata, Guido Basile
Original article, no. 5, 2025
Article DOI: 10.21614/chirurgia.3127
Background: Intestinal ischaemia is an abdominal emergency characterized by a drastic reduction in blood flow in the mesenteric vessels with the possible onset of necrosis of the small intestine and/or colon. Its incidence is rather rare and the diagnosis is very difficult as the clinical presentation is not specific and there are no pathognomonic laboratory tests.

Methods: A retrospective study was carried out on 28 patients with intestinal infarction, including analysis of the risk factors, comorbidities, symptoms, laboratory tests and instrumental investigations, to determine the presence of eventual signs of mesenteric ischaemia secondary to vascular insufficiency.

Results: Twenty-four patients (85%) underwent surgery and intestinal necrosis was found in all. Among these, a quite high mortality rate (64%) was observed.

Conclusion: The retrospective study confirmed the low frequency, high mortality and diagnostic difficulty of mesenteric ischaemia in its various clinical forms. Currently, there are neither laboratory tests nor instrumental techniques that can give a certain diagnosis of acute mesenteric ischaemia in an early phase. However, strong clinical suspicion, a rapid diagnosis and an aggressive therapeutic approach could improve the clinical results and reduce its high mortality.

Keywords: intestinal ischaemia, acute mesenteric ischaemia, bowel ischaemia, mesenteric arterial occlusion