Evaluation of outcome in Mesenteric Ischemia

Abstract

Background: Acute mesenteric ischemia (AMI) is an infrequent but a complicated life threatening condition. It is the leading causes of mortality with the rate of 60-100%. The purpose of our study is to investigate demographic outcomes of the patients referred to the emergency department of Imam Reza hospital with the diagnosis of AMI. Methods and materials: All patients with the diagnosis of AMI from March 2014 to March 2016 who were referred to emergency department of Imam Reza hospital, were studied. Demographic characteristics (age, sex, the period from symptom onset till laparotomy), risk factors and the last outcomes of patients were noted in the check lists for each patient. P value less than 0.05 was determined as significant. Results: from 111 patients, 76 cases (68.8%) were male, 35 cases (31.5%) were female. Chief complaint of all patients was stomachache. Period of arriving to the emergency room in 5 cases (4.5%) was 1-6 hours, in 3 cases (2.7%) was 6-12 hours, and in 103 cases (92.8%) has taken more than 12 hours. In 55 cases (49.5%), there was a significant relationship between clinical signs and physical examination findings, whereas in 56 cases (50.5%) there was no relation. In our study 42 cases (37.8%) were treated, whereas the morbidity and mortality rate were respectively 7 (6.3%) and 62 (55.9%). According to the results of our study the most important finding was pain which was disproportionate to physical examination findings (P value< 0.052). Conclusion: Acute mesenteric ischemia is a severe and progressive disease so early diagnosis and appropriate treatment are very important. One of the main reasons of higher mortality rate in AMI is difficulty in early diagnosis, before necrosis occurrence. Major factor that determines the survival rate is the accurate diagnosis before necrosis and peritonitis happens.