Nonocclusive mesenteric ischemia.

NOMI remains a challenging clinical entity that demands a heightened index of suspicion and an aggressive diagnostic and treatment strategy in order to avoid the untoward sequela of short bowel syndrome and to achieve survival. Early arteriographic diagnosis and prompt institution of vasodilator therapy have proven successful in reducing the high (70% to 90%) mortality rate observed through the 1980s to 50% to 55% during the last decade. Continued investigations into the pathophysiologic mechanisms underlying splanchnic vasospasm and intestinal IR injury will, it is hoped, add more alternate and effective therapies to the current armamentarium.