Mesenteric ischemia.

Mesenteric ischemia secondary to vascular disease remains a significant problem in patients presenting with acute abdominal conditions, especially if they are elderly. Although rare, it is nevertheless an important and perhaps increasing cause of death or significant morbidity. Occasionally, it may be a mode of dying, but more often, it is the reason for death. Individual cases can manifest an almost overwhelming spectrum from chronic to acute, mild to catastrophic, arterial to venous, occlusive to hemodynamic, extensive to limited, or precisely diagnosed to accidentally found. Treatment principles are well defined, but continued refinement of supportive therapies of several types is occurring. In contrast, improved screening tests that can lead to early specific etiologic diagnosis remain at the experimental stage. Thus, good "clinical suspicion" is foremost and essential.