Acute mesenteric ischemia in CMH, Rawalpindi | [Pakistan Armed Forces Medical Journal • 2020]

Author(s):

1. Anas Bin Saif: Combined Military Hospital Kohat,Pakistan

2. Shahzad Ahmed Abbasi: Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi,Pakistan

3. Irfan Ali Sheikh: Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi,Pakistan

4. Ammad Ud Din Nasir: Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

5. Misbah Rashid: Combined Military Hospital Peshawar Pakistan

6. Kashif Khan: Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi,Pakistan

7. Muddasar Liaquat: Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi,Pakistan

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.

Page(s): 166-170

DOI: DOI not available

Published: Journal: Pakistan Armed Forces Medical Journal, Volume: 70, Issue: 1, Year: 2020

Keywords:

Thromboembolism , Mesenteric ischemia , Radiologic imaging

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