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Acute Mesenteric Ischemia in the Elderly Patient

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Book cover Emergency General Surgery in Geriatrics

Part of the book series: Hot Topics in Acute Care Surgery and Trauma ((HTACST))

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Abstract

Acute mesenteric ischemia is an important surgical emergency in the elderly patient, owing to its increasing incidence with advanced age. The key for success relies on prompt diagnosis, requiring early computed tomography angiography, and immediate revascularization, increasingly through endovascular approach. In case of clinical, laboratory, or imaging signs of bowel necrosis, laparotomy is warranted to resect the necrosed bowel, usually in a damage-control setting, without stomas or anastomosis.

In this chapter, the authors review the key issues in the etiology, classification, diagnosis, and management of acute mesenteric ischemia in the elderly patient. In particular, since full resources may not always be available, we present two distinct treatment algorithms: one for a specialized center with all resources immediately available, including endovascular capability and/or vascular surgery; and another for settings with more limited resources, where the emergency surgeon may be called upon to offer definitive revascularization.

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Change history

  • 22 June 2021

    This chapter was initially published with incorrect Figure 18.9. This figure has now been updated with this erratum.

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Authors and Affiliations

  1. Serviço de Cirurgia Geral, Centro Hospitalar Tondela-Viseu, Viseu, Portugal

    Luís Filipe Pinheiro

  2. Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    Henrique Alexandrino & Beatriz Costa

  3. Coimbra University Hospital Center, Coimbra, Portugal

    Henrique Alexandrino & Beatriz Costa

  4. Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    Henrique Alexandrino & Beatriz Costa

Authors
  1. Luís Filipe Pinheiro
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  2. Henrique Alexandrino
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  3. Beatriz Costa
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Editor information

Editors and Affiliations

  1. Department of Surgery, New York Medical College, School of Medicine and Westchester Medical Center, Valhalla, NY, USA

    Rifat Latifi

  2. Emergency Surgery Department, Parma University Hospital, Parma, Italy

    Fausto Catena

  3. General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy

    Federico Coccolini

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Pinheiro, L.F., Alexandrino, H., Costa, B. (2021). Acute Mesenteric Ischemia in the Elderly Patient. In: Latifi, R., Catena, F., Coccolini, F. (eds) Emergency General Surgery in Geriatrics . Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-030-62215-2_18

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