Acute Mesenteric Ischemia: Complications

00:01 There are some complications.

00:03 Again, this is a very serious diagnosis, and one that you wanna be sure that you're not missing at all.

00:08 So the first is reperfusion injury, so if you go in, or the interventional radiologist goes in, and they remove that blood clot, blood flow is gonna be restored very immediately to that tissue.

00:20 And as that blood flow is restored to the tissue that can sometimes cause a reperfusion injury, so it can cause further potential damage to those cells and to that intestinal wall.

00:31 Infection is the other complication you definitely wanna be worry of infection, go ahead and treat early with antibiotics as indicated for the patient, and then sepsis as well can be a concerning complication.

00:44 So the conclusions here, mesenteric ischemia is a vascular catastrophe.

00:49 Patients are often quite ill, this is something that you wanna recognize immediately in the Emergency Department and have this on your differential of consequence for patients who are presenting with abdominal pain.

01:01 Acute mesenteric ischemia is most common in patient that are older and patients that have a cardiac history.

01:08 Patients who have atrial dysrhythmias.

01:10 Lactic acid level is gonna be your most important and most helpful lab test to get.

01:16 CT Angiography is your first-line test for mesenteric ischemia in most Emergency Departments.

01:23 And then involve the surgery team early, especially in patients have signs of perforation or peritonitis.

01:30 You also wanna definitely think about the cause of the mesenteric ischemia, because not all of them are treated equal.

01:37 So is this related to an arterial occlusion? Is it related to vasospasm, or related to a venous thrombosis? All of those conditions potentially we get different treatment, and different dispositions from the Emergency Department.