Research Article

Result Of Surgical Therapy In Acute Mesenteric Ischemia

  • Muhammet Akyüz
  • Erdoğan Sözüer
  • Hızır Akyıldız
  • Alper Akcan
  • Can Küçük
  • Bilgehan Poyrazoğlu

Turk J Colorectal Dis 2010;20(3):121-126


Acute mesenteric ischemia (AMI) is a condition with high mortality rate. The aim of this study was to investigate the results of surgical therapy and factors related to high mortality rate.


A retrospective analysis of 196 patients who were operated for AMI between June 2001 and December 2008 was performed


Mean patient’s age was 65 ± 12.4 (32–89). The most common presenting symptoms were abdominal pain (% 100) and nausea-vomiting (% 66). Admission time was in more than 24 hours after the onset of symptoms in % 76 of patients. Patients usually had at least one comorbid disease. Hypertension (% 40), ischemic heart disease (% 31) and atrial fibrillation (% 30) were the most commons. Physical examination findings were tenderness (% 81), guarding (% 60), rebound tenderness (% 30) and decreased bowel sounds (% 70). Remarkable white blood cell count (> 20000/mm3) was measured in 88 patients (% 45). The etiology was arterial thromboembolism in 178 patients (% 91), mesenteric venous thrombosis in 12 patients (% 12) and nonocclusive ischemia in 6 patients (% 6). During the surgical exploration a total bowel necrosis were seen in 78 patients (% 40). Massive and partial bowel resection were performed in 60 (% 30) and in 58 patients (% 29.5) respectively. Second look operations were done in %21 of patients. Overall mortality rate was % 81. Age, gender, admission time to hospital and comorbid disease were found to related to mortality.


Late admission of patients, multiple comorbid diseases and late diagnosis due to absent of typical symptoms are responsible for high mortality rate in AMI.

Keywords: Acute mesenteric ischemia, mesenteric vein thrombosis, nonocclusive mesenteric ischemia, second look