ACUTE MESENTERIC ISCHEMIA IN CMH, RAWALPINDI

Abstract

Objective: To assess the clinical presentation, laboratory/radiological findings and operative findings in a series of patients diagnosed as Acute Mesenteric Ischemia at Combined Military Hospital Rawalpindi.

Study Design: Case series study.

Place and Duration of Study: Study was carried out at Combined Military Hospital Rawalpindi, from Jan 2016 to Jun 2016.

Methodology: Study included all the cases of the Acute Mesenteric Ischemia admitted in the wards and intensive care unit. Clinical history, examination findings and radiological variables were studied. Per-operative findings were also noted. Follow up was done to look for the prognosis.

Results: Of the twelve patients diagnosed with Acute Mesenteric Ischemia all were male. Two patients were below 50 years of age. Seven patients had pre-existing cardiovascular disease. Abdominal pain (90%) was the most common complaint and tenderness and re-bound tenderness was elicited in 10 patients. Most common ultrasonography finding was presence of free peritoneal fluid present in 6 patients. Computed tomography scan of patient showed classical signs in only 2 cases. Per-operatively Superior mesenteric artery was involved in 8 cases. The most common cause of Acute Mesenteric Ischemia was thromboembolism in 7 (58%) cases. Mortality rate was 50% and most common post-operative complication was respiratory distress requiring ventilator support in 8 (67%) cases.

Conclusion: Acute Mesenteric Ischemia is an abdominal emergency which presents with a variety of equivocal symptoms. Conventional laboratory and radiologic imaging help little in its diagnosis. High index of suspicion, early recognition and prompt treatment result in a better outcome.