Title: Acute Mesenteric Ischemi a (AMI): A surgical perspective
Acute mesenteric ischemia (AMI) is a rare surgical emergency as it involves perfusion and need frequent surgical interventions. It is a life threatening emergency with a poor prognosis. It is classified according to the etiological basis thromboembolism, n on - obstructive and venous origin. AMI has various risk factors ranging from cardiac arrhythmias to the intraabdominal hypertension. Apart from the signs and symptoms , the mu l ti - detector computer tomography remains a diagnostic tool with accuracy. In the ma nagement of AMI patients’ initial resuscitation, hydration and analgesia play important role , however the operative /interventional management is either endovascular thrombectomy with or without stenting when there is no bowel involvement or peritonitis. T he laparotomy with open vascular thrombectomy with vascular graft, it is indicated when bowel involvement and peritonitis patients. Often the whole bowel is gangrenous and no further treatment is needed because of certain mortality. The 2 nd step is to know the extent of bowel involvement meticulously and resection of bowel with necrosis or gangrene with anastomosis, further relook laparotomies and resection of the bowel may be need. Initially abdomen will be closed with Bagota bag or VAC (Vacuum Assisted Cl osed) dressing and final staged abdominal closer, once pathology resolves complete ly. As fa r as prevention of all types of AMI is considered, to date there are no proven preventive measures are available.
Keywords: Acute mesenteric ischemia, anti - coagulation, bowel ischemia, bowel resection, endovascular interventions, inferior mesenteric artery and vein open surgical thrombectomy, small and large bowel, superior mesenteric artery and vein, staged abdominal closer.