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Diagn Interv Imaging · Mar 2018
ReviewAcute mesenteric ischemia: A critical role for the radiologist.
- P Copin, M Zins, A Nuzzo, Y Purcell, S Beranger-Gibert, L Maggiori, O Corcos, V Vilgrain, and M Ronot.
- Department of Radiology, University Hospitals Paris Nord Val-de-Seine, Beaujon, 92110 Clichy, Hauts-de-Seine, France; University Paris Diderot, Sorbonne Paris Cité, 75018 Paris, France.
- Diagn Interv Imaging. 2018 Mar 1; 99 (3): 123-134.
AbstractAcute mesenteric ischemia is defined as an inadequate blood supply to the gastrointestinal tract resulting in ischemic and inflammatory injury that may progress to necrosis of the bowel wall. Prognosis is poor with a mortality rate greater than 95% without treatment, dropping to around 70% when surgical treatment is performed. Contrast-enhanced computed tomography (CT) has become the cornerstone of the diagnosis by showing features of vascular disorders (occlusion and/or insufficient blood supply) and features of intestinal ischemic injury. CT should be performed as rapidly as possible. Imaging-based patient management is required, and multimodal and multidisciplinary management should be introduced. The treatment involves multidisciplinary management by gastroenterologists, vascular and digestive surgeons, cardiologists, intensivists, and diagnostic and interventional radiologists. Based on our experience at a dedicated mesenteric stroke center, this article gives an overview of the diagnosis of acute mesenteric ischemia. The goal of this review is to improve the understanding of the imaging-based diagnosis to further improve the management of this life-threatening condition.Copyright © 2018 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.
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