Introduction/Objective: Acute mesenteric ischemia (AMI) is difficult to diagnose. Since the established parameters have low sensitivity and specificity, the aim of this study is to analyze the diagnostic quality of the established parameters of AMI. Methods: All patients that underwent emergency surgery due to suspected diagnosis of mesenteric ischemia at the University Medical Center Hamburg-Eppendorf between 2008 and 2014 were evaluated. Overall, 275 patients were enrolled and pre-, intra- and postoperative data were evaluated. Results: In 200 patients, a mesenteric ischemia was confirmed intraoperatively, and 75 patients had no ischemia. Comparing these groups, the rate of patients with pH #x3c; 7.2 (25 vs. 12%; p = 0.021) and elevated mean CRP level (175 ± 117 mg/L vs. 139 ± 104 mg/L; p = 0.019) was significantly higher in ischemic patients. There was no significant difference in the level of preoperative lactate. Concerning abdominal CT scan, a sensitivity and specificity of 61 and 68%, respectively, was found. Conclusion: New diagnostic parameters are needed. So far, explorative laparotomy is the only reliable diagnostic method to detect mesenteric infarction.
Dig Surg

中文翻译：

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急性肠系膜梗死：评估急性肠系膜缺血诊断参数质量的急性腹部变色龙

介绍/目的：急性肠系膜缺血 (AMI) 难以诊断。由于已建立的参数敏感性和特异性较低，本研究的目的是分析已建立的 AMI 参数的诊断质量。方法：对 2008 年至 2014 年在汉堡-埃彭多夫大学医学中心因疑似肠系膜缺血而接受急诊手术的所有患者进行评估。总共招募了 275 名患者，并对术前、术中和术后数据进行了评估。结果： 200例术中确诊肠系膜缺血，75例无缺血。比较这些组，pH #x3c 的患者比例；7.2（25 对 12%； p= 0.021) 和升高的平均 CRP 水平（175 ± 117 mg/L vs. 139 ± 104 mg/L；p = 0.019）在缺血患者中显着更高。术前乳酸水平无显着差异。腹部 CT 扫描的敏感性和特异性分别为 61% 和 68%。结论：需要新的诊断参数。迄今为止，剖腹探查是唯一可靠的肠系膜梗死诊断方法。
挖掘手术