[Acute mesenteric ischemia-An overview and recommendations (S2k analogous) of the World Society of Emergency Surgery].

Autor: Reichert M; Klinik für Allgemein‑, Viszeral‑, Thorax‑, Transplantations- und Kinderchirurgie, Universitätsklinikum Gießen, Rudolf-Buchheim-Straße 7, 35392, Gießen, Deutschland., Roller FC; Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Gießen, Klinikstraße 33, 35392, Gießen, Deutschland., Kalder J; Klinik für Herz‑, Kinderherz- und Gefäßchirurgie, Universitätsklinikum Gießen, Rudolf-Buchheim-Straße 7, 35392, Gießen, Deutschland., Hecker M; Klinik für Innere Medizin II - Pneumologie, Gastroenterologie, Nephrologie und internistische Intensivmedizin, Universitätsklinikum Gießen, Klinikstraße 33, 35392, Gießen, Deutschland., Bala M; Trauma and Acute Care Surgery Unit, Hadassah - Hebrew University Medical Center, Jerusalem, Israel., Catena F; Department of General and Emergency Surgery, 'Maurizio Bufalini' Hospital, Cesena, Italien., Biffl W; Department of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, USA., Coccolini F; Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italien., Moore EE; Ernest E Moore Shock Trauma Center at Denver Health, University of Colorado, Denver, USA., Ansaloni L; Department of Surgery, Pavia University Hospital, Pavia, Italien., Damaskos D; Department of Surgery, Royal Infirmary of Edinburgh, Edinburgh, Schottland, United Kingdom., Sartelli M; Department of Surgery, Macerata Hospital, Macerata, Italien., Padberg W; Klinik für Allgemein‑, Viszeral‑, Thorax‑, Transplantations- und Kinderchirurgie, Universitätsklinikum Gießen, Rudolf-Buchheim-Straße 7, 35392, Gießen, Deutschland., Hecker A; Klinik für Allgemein‑, Viszeral‑, Thorax‑, Transplantations- und Kinderchirurgie, Universitätsklinikum Gießen, Rudolf-Buchheim-Straße 7, 35392, Gießen, Deutschland. Andreas.Hecker@chiru.med.uni-giessen.de.
Jazyk: němčina
Zdroj: Chirurgie (Heidelberg, Germany) [Chirurgie (Heidelb)] 2023 Jul; Vol. 94 (7), pp. 608-615. Date of Electronic Publication: 2023 Jun 19.
DOI: 10.1007/s00104-023-01913-x
Abstrakt: Acute mesenteric ischemia is a severe illness, which if untreated, rapidly leads to a critical condition with sepsis, multiple organ failure and death in affected patients. The diagnosis and initiation of treatment of acute mesenteric ischemia should be performed as early and expeditiously as possible and follows the principle of the shortest possible time to reperfusion. Otherwise, the outcome of the patient rapidly deteriorates. The treatment algorithm should be adapted to the pathogenesis of the ischemia, the clinical condition and symptoms of the patients. With clinical signs of peritonitis, intestinal gangrene must be assumed and the abdomen should be surgically explored to detect and treat possible foci of sepsis at an early stage. The treatment of acute mesenteric ischemia should always be performed by an interdisciplinary team with all surgical and interventional options for intestinal revascularization as well as comprehensive intensive care medicine according to the standards of the Intestinal Stroke Center described in the literature. A short duration to revascularization and treatment in this interdisciplinary concept improves the outcome of patients with acute mesenteric ischemia. The World Society of Emergency Surgery provides expert consensus-based recommendations for the diagnosis and treatment of acute mesenteric ischemia; however, there is still a significant lack of broad high-quality evidence for this critical illness. Recommendations of the German specialist societies are urgently needed to ensure appropriate care, from the initial diagnostics to treatment and aftercare, for patients with suspected mesenteric ischemia in this country.
(© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
Databáze: MEDLINE
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