Mesenteric ischemia medical therapy

Jump to navigation Jump to search


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

Mesenteric ischemia is a medical emergency and requires prompt treatment. The mainstay of treatment is surgery, whereas medical therapy is considered initially for hemodynamically unstable patients.

Medical Therapy

Initial management:

Mesenteric ischemia is an acute emergency condition that requires prompt intervention. The outline of initial management of all types of meseneteric ischemia includes:

  • Pain control
  • Fluid resuscitation
  • Hemodynamic support and monitoring
  • Correction of electrolyte abnormalities
  • Anticoagulation
  • Broad sprectrum antibiotics
  • Gastrointestinal decompression
  • Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
  • Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
  • Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].

Further

Multimodal management of mesenteric ischemia
Early management Late management
Pathophysiological events Vascular occlusion Splanchnic hypoperfusion Intestinal hypoxia
  • Intestinal barrier injury
  • Translocation
  • Local inflammatory pathway
Systemic inflammatory pathways Necrosis

Organ failure

Treatment strategy
  • Heparin
  • Aspirin
  • Revascularization
  • Oxygen
  • Blood volume resuscitation
  • Transfusion
Oral antibiotics Intravenous antibiotics Intestinal resection

Disease Name