DIAGNOSIS OF MESENTERIC ISCHEMIA

Abstract

Mesenteric ischemia consists of a reduction in blood flow to the visceral organs, resulting in metabolic impairment, tissue injury, and, in advanced cases, intestinal necrosis. The acute form constitutes a surgical emergency with high mortality, especially when diagnosis is delayed, whereas the chronic form presents an insidious course, often associated with atherosclerotic disease. The initial clinical presentation, frequently nonspecific, makes early recognition difficult, requiring a high degree of clinical suspicion. Biphasic computed tomography angiography is currently the main diagnostic method, allowing the identification of vascular occlusions and secondary changes associated with intestinal ischemia. In contrast, laboratory tests such as lactate and D-dimer have low specificity and are useful only as auxiliary tools. Additionally, emerging biomarkers, such as intestinal fatty acid-binding protein, show potential for early detection of lesions, although they are not yet widely established in clinical practice. In this context, the present study aimed to review the main diagnostic methods for mesenteric ischemia, with emphasis on imaging exams, clinical findings, and biomarkers. This is a narrative literature review based on the analysis of recent studies on the topic. The findings reinforce that the diagnostic approach depends on the integration of clinical suspicion and imaging methods, which is essential for appropriate therapeutic management and reduction of mortality.