Acute mesenteric ischemia: a comparative study of causes and mortality rates in Shiraz, Southern Iran

Introduction

Acute mesenteric ischemia (AMI) is a catastrophic disorder of the gastrointestinal tract with high mortality. Owing to recognition in advanced stages and late treatment of patients with AMI, this disease is still considered a highly lethal condition. There are few data on characteristics of this disease in Iran, so this study was conducted to determine characteristics of this disease in the population.

Methods

In a retrospective study, all patient records of public and private hospitals in Shiraz, Southern Iran, with an impression of acute abdomen, bowel gangrene or abdominal pain, and patients with risk factors for this disease, who were admitted from March 1989 to March 2005, were reviewed, and those with AMI were identified, analyzed and compared with other research.

Results

Among the 10,000 patient records studied, 105 patients with AMI were identified. The mean age of patients was 57 years. The most common symptoms were abdominal pain (98.09%), vomiting (68.5%) and constipation (36.1%). Heart diseases were seen in 44.7% of cases. The mortality rate in patients with AMI was 50.5%. The mortality rate was lower in patients undergoing mesenteric angiography (P = 0.014). In those patients in whom the site of lesion was exactly defined, 41.9% of cases were due to venous thrombosis, 25.7% due to mesenteric arterial emboli, 19% due to mesenteric arterial thromboses, and 8.5% were of nonocclusive types.

Conclusion

AMI is a relatively common cause of acute abdomen especially in old patients referred to Shiraz hospitals, with venous thrombosis being the most common type. Early diagnosis especially with early use of mesenteric angiography and treatment may decrease the mortality from AMI.