Mesenteric Ischemia: From Basics to Clinical Application

Abstract

Mesenteric ischemia can be life-threatening despite the advances made in diagnosis and treatment. Acute mesenteric ischemia is potentially reversible when a timely diagnosis is made. The radiologist plays a central role in the initial diagnosis and in preventing progression to irreversible intestinal ischemic injury or bowel necrosis. The imaging findings described in the literature are either non-specific or only present in the late stages of acute mesenteric ischemia, urging the use of a constellation of features to arrive at a confident diagnosis. While acute mesenteric ischemia has been traditionally categorized based on the etiology with a wide spectrum of imaging findings overlapping with each other, the final decision for patient›s management is usually made on the stage of the acute mesenteric ischemia concerning the underlying pathophysiology. In this presentation, the pathologic stages of ischemia will be discussed. Then the various imaging signs and causes of mesenteric ischemia will be summarized. The correlation between imaging findings and pathological staging of the disease will also be emphasized. In the end, a clinical management approach will be suggested using combined clinical and radiological findings to determine whether the patient may benefit from surgery or conservative management