THERAPEUTIC MANAGEMENT OF ACUTE MESENTERIC ISCHEMIA

Abstract

Introduction: Acute mesenteric ischemia (AMI) is a vascular emergency that occurs when there is a sudden interruption of blood flow to the visceral organs. Because it presents symptoms similar to other common abdominal diseases, it is often overlooked in the early stages.

Objective: To gather and systematize the most recent evidence on the diagnosis and treatment of AMI, focusing on strategies to improve patient outcomes.

Methodology: A narrative literature review was conducted using the PubMed database, including articles published in the last five years, available in full text in Portuguese or English.

Results and Discussion: Computed tomography angiography has become the gold standard for the diagnosis of AMI, as it allows precise visualization of vascular obstructions and intestinal wall changes. The therapeutic approach depends on the cause of ischemia. In arterial occlusions, revascularization is prioritized, either through surgery or endovascular techniques. In mesenteric venous thrombosis, the initial treatment is clinical, with anticoagulation. In arterial occlusion, the main priority is restoring adequate blood flow. In non-occlusive ischemia, the focus is on correcting low blood flow states and using vasodilators. In cases with suspected intestinal necrosis, laparotomy is essential to assess bowel viability.

Conclusion: Early diagnosis, combined with imaging methods such as computed tomography angiography, is essential for the rapid definition of therapeutic management. Thus, timely initiation of appropriate treatment is crucial to reduce morbidity and mortality and improve patient prognosis.