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肠系膜缺血的影像学检查与血管内介入治疗

Imaging and endovascular interventions in mesenteric ischaemia.

作者信息

Agarwal Divij, Gupta Sanchita, Gadwal Sai Krishna, Singh Anand Narayan, Sarda Prashant, Das Chandan J

机构信息

Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, Delhi, India.

Department of Gastrointestinal Surgery and Liver Transplantation, All India Institute of Medical Sciences, Delhi, India.

出版信息

Abdom Radiol (NY). 2025 Jul 11. doi: 10.1007/s00261-025-05038-z.

Abstract

Mesenteric ischaemia is a rare cause of abdominal pain caused by a reduction in blood flow to the small or large bowel. It typically has a non-specific clinical presentation, which causes diagnostic delays, that have a major impact on clinical outcome, resulting in high disease morbidity and death. Acute mesenteric ischemia is a life-threatening illness that necessitates high clinical suspicion and early imaging examination for accurate diagnosis. Chronic mesenteric ischemia caused by atherosclerotic arterial disease can result in severe patient morbidity with postprandial pain and food aversion, leading to malnutrition and unintentional weight loss. While endovascular therapies are more well-established in treating chronic mesenteric ischemia, they are also becoming increasingly popular in treating acute mesenteric ischemia. This review delves into the pathogenesis, clinical characteristics, classification, imaging, and minimally invasive endovascular therapies for mesenteric ischaemia.

摘要

肠系膜缺血是一种由小肠或大肠血流减少引起的腹痛罕见病因。其临床表现通常不具有特异性,这会导致诊断延误,而诊断延误对临床结果有重大影响,从而导致高发病率和高死亡率。急性肠系膜缺血是一种危及生命的疾病,需要高度的临床怀疑和早期影像学检查以进行准确诊断。由动脉粥样硬化性疾病引起的慢性肠系膜缺血可导致患者出现严重发病情况,伴有餐后疼痛和厌食物,进而导致营养不良和非故意性体重减轻。虽然血管内治疗在治疗慢性肠系膜缺血方面更为成熟,但在治疗急性肠系膜缺血方面也越来越受欢迎。本综述深入探讨了肠系膜缺血的发病机制、临床特征、分类、影像学以及微创血管内治疗。

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