ESTES guidelines: acute mesenteric ischaemia

• Published in: European journal of trauma and emergency surgery (Munich : 2007) Vol. 42; no. 2; pp. 253 - 270
• Main Authors: Tilsed, J. V. T., Casamassima, A., Kurihara, H., Mariani, D., Martinez, I., Pereira, J., Ponchietti, L., Shamiyeh, A., al-Ayoubi, F., Barco, L. A. B., Ceolin, M., D’Almeida, A. J. G., Hilario, S., Olavarria, A. L., Ozmen, M. M., Pinheiro, L. F., Poeze, M., Triantos, G., Fuentes, F. T., Sierra, S. U., Soreide, K., Yanar, H.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2016; Springer Nature B.V
• Subjects: Anti-Bacterial Agents - therapeutic use; Anticoagulants - therapeutic use; Critical Care Medicine; Early Diagnosis; Early Medical Intervention - methods; Emergency Medicine; ESTES Guideline; Fluid Therapy - methods; Guidelines; Humans; Intensive; Ischemia; Medical diagnosis; Medicine; Medicine & Public Health; Mesenteric Ischemia - diagnosis; Mesenteric Ischemia - diagnostic imaging; Mesenteric Ischemia - etiology; Mesenteric Ischemia - physiopathology; Mesenteric Ischemia - surgery; Multidetector Computed Tomography - methods; Oxygen Inhalation Therapy - methods; Patients; Practice Guidelines as Topic; Risk Assessment - methods; Sports Medicine; Surgery; Surgical Orthopedics; Symptom Assessment - methods; Traumatic Surgery; Vascular Surgical Procedures - methods; Clinical management; Diagnosis; Acute mesenteric ischaemia; Guidelines
• ISSN: 1863-9933; 1863-9941; 1863-9941
• DOI: 10.1007/s00068-016-0634-0

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.