Department of Gastroenterology, IBD, Nutritional Support and Intestinal Transplantation, Beaujon Hospital Clichy, Paris VII University, 100 Boulevard du General Leclerc, 92110 Clichy, France.
Best Pract Res Clin Gastroenterol. 2013 Oct;27(5):709-25. doi: 10.1016/j.bpg.2013.08.006. Epub 2013 Sep 5.
Gastro-Intestinal Vascular Emergencies include all digestive ischaemic injuries related to acute or chronic vascular and/or haemodynamic diseases. Gastro-intestinal ischaemic injuries can be occlusive or non-occlusive, arterial or venous, localized or generalized, superficial or transmural and share the risks of infarction, organ failure and death. The diagnosis must be suspected, at the initial presentation of any sudden, continuous and unusual abdominal pain, contrasting with normal physical examination. Risk factors are often unknown at presentation and no biomarker is currently available. The diagnosis is confirmed by abdominal computed tomography angiography identifying intestinal ischaemic injury, either with vascular occlusion or in a context of low flow. Recent knowledge in the pathophysiology of acute mesenteric ischaemia, clinical experience and existing recommendations have generated a multimodal and multidisciplinary management strategy. Based on the gastro-intestinal viability around a simple algorithm, and coordinated by gastroenterologists, the dual aim is to avoid large intestinal resections and death.
胃肠道血管急症包括所有与急性或慢性血管和/或血流动力学疾病相关的消化道缺血性损伤。胃肠道缺血性损伤可以是闭塞性或非闭塞性、动脉性或静脉性、局限性或弥漫性、表浅性或透壁性，并具有梗死、器官衰竭和死亡的风险。在任何突然、持续和异常的腹痛的初始表现时，必须怀疑存在胃肠道血管急症，这与正常的体格检查相反。在就诊时，风险因素通常不明确，目前尚无生物标志物可用。腹部 CT 血管造影可以识别肠缺血性损伤，包括血管闭塞或低血流状态，从而确诊。急性肠系膜缺血的病理生理学、临床经验和现有推荐的新知识，催生了一种多模式和多学科的管理策略。基于简单算法的胃肠道活力，由胃肠病学家进行协调，双重目标是避免大肠切除术和死亡。
