ObjectiveTo summarize the manifestations of acute mesenteric ischemia (AMI) on multidetector computed tomography (MDCT) and the diagnostic value of MDCT in the prognosis of AMI. MethodRecent studies on pathophysiology, CT features, and prognosis of AMI were retrieved and reviewed. ResultsVascular insufficiency of AMI could occur as a result of mesenteric arterial embolism, arterial thrombosis, venous thrombosis, or nonocclusive. Two stages of AMI, early and late, were associated with distinct prognosis. In early ischemia, the lesions were reversible. The late AMI was characterized by the development of irreversible transmural necrosis. A delayed diagnosis leaded to considerable mortality. MDCT findings in AMI could be divided into imaging findings related to vascular insufficiency and ischemic intestinal injury. Pneumoperitoneum could be considered a sign of transmural necrosis in the AMI. While, other imaging features predicting transmural necrosis were controversial because of the heterogeneity of diagnostic tests. ConclusionsAMI is a life-threatening abdominal emergency. Early diagnosis can improve the prognosis of patient. It is important for radiologists to identify prognostic features for differentiating early from late forms of AMI.
Acute mesenteric ischemia (AMI) refers to a group of acute abdominal conditions resulting from impaired mesenteric blood supply, characterized by low incidence but high mortality. Early diagnosis and prompt intervention are crucial for reducing AMI-related fatalities and improving patients’ outcomes, with surgical treatment playing a key role. To address challenges in the surgical management of AMI, the Laparoscopic Surgery Committee of the Endoscopist Branch of the Chinese Medical Doctor Association, the Robotic and Laparoscopic Surgery Committee of Chinese Research Hospital Association, the Peripheral Vascular Disease Management Branch of the Chinese Geriatrics Society, the Emergency Medicine Branch of Chinese Geriatrics Society, and the Multidisciplinary Committee for Gastrointestinal Diseases of Sichuan Medical Association have jointly organized experts in the field to develop this consensus. The document aims to enhance clinical awareness of AMI, standardize surgical diagnosis and treatment protocols, and ultimately improve the prognosis of AMI patients.