Revisión bibliográfica sobre isquemia mesenterica aguda: clasificación, diagnóstico y manejo actual

Abstract

Acute mesenteric ischemia is a rare entity, but with a high mortality rate greater than 60%, constituting a surgical emergency, characterized by decreased blood flow to the intestine that develops over hours or days, whose main cause is the embolic processes. It occurs most often in older adults around 70 years of age. (1)(2) The clinical presentation is very nonspecific and varies according to the cause that produces it, but sudden abdominal pain predominates in most patients. Its diagnosis is a real challenge and requires the combination of clinical, laboratory and imaging findings. Computed tomography angiography allows us to establish the diagnosis and the possible cause: arterial embolism, arterial thrombosis, venous thrombosis or nonocclusive ischemic syndrome. Initial management is based on bowel decompression; resuscitation with fluid therapy to correct hypovolemia that may occur, hemodynamic support, electrolyte correction, correction of acid-base balance, monitoring of vital signs and specific treatment according to the cause of intestinal ischemia. (1)(2) (3)