Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
Division of Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA.
Curr Gastroenterol Rep. 2020 Mar 17;22(4):17. doi: 10.1007/s11894-020-0754-x.
Mesenteric ischemia (MI), both acute (AMI) and chronic (CMI), is a challenging diagnosis to make, and early diagnosis and treatment are vital to improve outcomes. This manuscript summarizes the most up to date information on diagnosis and treatment of these disorders.
There have been several significant advancements in the computed tomography (CT) diagnostic imaging as well as medical and endovascular management of AMI and CMI. In appropriate populations, endovascular interventions appear superior to open surgical management with lower mortality, morbidity, and cost of care. Efficient clinical identification and targeted testing are essential to diagnose AMI and CMI. Aggressive resuscitation and early endovascular (or in select cases, surgical) intervention improve outcomes in those with AMI. In those with CMI, considering this on the differential diagnosis and imaging appropriately can identify those that might benefit from intervention and halt progression to acute episodes.
肠系膜缺血（MI），包括急性（AMI）和慢性（CMI），是一种具有挑战性的诊断，早期诊断和治疗对于改善预后至关重要。本文总结了这些疾病诊断和治疗的最新信息。
在计算机断层扫描（CT）诊断成像以及 AMI 和 CMI 的医学和血管内治疗方面都取得了一些重大进展。在适当的人群中，血管内介入治疗的死亡率、发病率和治疗成本均低于开放手术治疗。有效的临床识别和有针对性的检测对于诊断 AMI 和 CMI 至关重要。急性肠系膜缺血患者积极的复苏和早期血管内（或在某些情况下，手术）干预可改善预后。对于慢性肠系膜缺血患者，在鉴别诊断和适当的影像学检查时考虑到这一点，可以识别出那些可能受益于介入治疗并阻止其进展为急性发作的患者。
