ESTES guidelines: acute mesenteric ischaemia

J.V. Tilsed*, A. Casamassima, H. Kurihara, D. Mariani, I. Martinez, J. Pereira, L. Ponchietti, A. Shamiyeh, F. Al-Ayoubi, L.A. Barco, M. Ceolin, A.J. D'Almeida, S. Hilario, A.L. Olavarria, M.M. Ozmen, L.F. Pinheiro, Martijn Poeze - van Bokhoven, G. Triantos, F.T. Fuentes, S.U. SierraK. Soreide, H. Yanar

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

PURPOSE: Acute mesenteric ischaemia (AMI) accounts for about 1:1000 acute hospital admissions. Untreated, AMI will cause mesenteric infarction, intestinal necrosis, an overwhelming inflammatory response and death. Early intervention can halt and reverse this process leading to a full recovery, but the diagnosis of AMI is difficult and failure to recognize AMI before intestinal necrosis has developed is responsible for the high mortality of the disease. Early diagnosis and prompt treatment are the goals of modern therapy, but there are no randomized controlled trials to guide treatment and the published literature contains a high ratio of reviews to original data. Much of that data comes from case reports and often small, retrospective series with no clearly defined treatment criteria. METHODS: A study group of the European Society for Trauma and Emergency Surgery (ESTES) was formed in 2013 with the aim of developing guidelines for the management of AMI. A comprehensive literature search was performed using the Medical Subject Heading (MeSH) thesaurus keywords "mesenteric ischaemia", "bowel ischaemia" and "bowel infarction". The bibliographies of relevant articles were screened for additional publications. After an initial systematic review of the literature by the whole group, a steering group formulated questions using a modified Delphi process. The evidence was then reviewed to answer these questions, and recommendations formulated and agreed by the whole group. RESULTS: The resultant recommendations are presented in this paper. CONCLUSIONS: The aim of these guidelines is to provide recommendations for practice that will lead to improved outcomes for patients.
Original languageEnglish
Pages (from-to)253-270
Number of pages18
JournalEuropean Journal of Trauma and Emergency Surgery
Volume42
Issue number2
DOIs
Publication statusPublished - Apr 2016

Keywords

  • Acute mesenteric ischaemia
  • Diagnosis
  • Clinical management
  • Guidelines
  • ACUTE INTESTINAL ISCHEMIA
  • DAMAGE CONTROL SURGERY
  • EARLY-DIAGNOSIS
  • SURGICAL-MANAGEMENT
  • COMPUTED-TOMOGRAPHY
  • HYDROXYETHYL STARCH
  • VENOUS THROMBOSIS
  • VEIN-THROMBOSIS
  • RISK-FACTORS
  • PERIOPERATIVE MORTALITY

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