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Tilsed J.V.T.,Hull and East Yorkshire Hospitals NHS Trust | Casamassima A.,Instituto Clinico Citta Studi | Kurihara H.,Humanitas Research Hospital | Mariani D.,Ospedale di Legnano | And 19 more authors.
European Journal of Trauma and Emergency Surgery | Year: 2016

Purpose: Acute mesenteric ischaemia (AMI) accounts for about 1:1000 acute hospital admissions. Untreated, AMI will cause mesenteric infarction, intestinal necrosis, an overwhelming inflammatory response and death. Early intervention can halt and reverse this process leading to a full recovery, but the diagnosis of AMI is difficult and failure to recognize AMI before intestinal necrosis has developed is responsible for the high mortality of the disease. Early diagnosis and prompt treatment are the goals of modern therapy, but there are no randomized controlled trials to guide treatment and the published literature contains a high ratio of reviews to original data. Much of that data comes from case reports and often small, retrospective series with no clearly defined treatment criteria. Methods: A study group of the European Society for Trauma and Emergency Surgery (ESTES) was formed in 2013 with the aim of developing guidelines for the management of AMI. A comprehensive literature search was performed using the Medical Subject Heading (MeSH) thesaurus keywords “mesenteric ischaemia”, “bowel ischaemia” and “bowel infarction”. The bibliographies of relevant articles were screened for additional publications. After an initial systematic review of the literature by the whole group, a steering group formulated questions using a modified Delphi process. The evidence was then reviewed to answer these questions, and recommendations formulated and agreed by the whole group. Results: The resultant recommendations are presented in this paper. Conclusions: The aim of these guidelines is to provide recommendations for practice that will lead to improved outcomes for patients. © 2016, The Author(s).


PubMed | Rhodes General Hospital, Hospital Sao Teotonio, Galdakao Usansolo Hospital, Ospedale di Legnano and 17 more.
Type: Journal Article | Journal: European journal of trauma and emergency surgery : official publication of the European Trauma Society | Year: 2016

Acute mesenteric ischaemia (AMI) accounts for about 1:1000 acute hospital admissions. Untreated, AMI will cause mesenteric infarction, intestinal necrosis, an overwhelming inflammatory response and death. Early intervention can halt and reverse this process leading to a full recovery, but the diagnosis of AMI is difficult and failure to recognize AMI before intestinal necrosis has developed is responsible for the high mortality of the disease. Early diagnosis and prompt treatment are the goals of modern therapy, but there are no randomized controlled trials to guide treatment and the published literature contains a high ratio of reviews to original data. Much of that data comes from case reports and often small, retrospective series with no clearly defined treatment criteria.A study group of the European Society for Trauma and Emergency Surgery (ESTES) was formed in 2013 with the aim of developing guidelines for the management of AMI. A comprehensive literature search was performed using the Medical Subject Heading (MeSH) thesaurus keywords mesenteric ischaemia, bowel ischaemia and bowel infarction. The bibliographies of relevant articles were screened for additional publications. After an initial systematic review of the literature by the whole group, a steering group formulated questions using a modified Delphi process. The evidence was then reviewed to answer these questions, and recommendations formulated and agreed by the whole group.The resultant recommendations are presented in this paper.The aim of these guidelines is to provide recommendations for practice that will lead to improved outcomes for patients.

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