Recognizing acute mesenteric ischaemia too late: Reasons and diagnostic approach from a surgical point of view

Survival of patients with acute mesenteric ischaemia is decisively dependent upon early diagnosis and undelayed treatment. Maximum shortening of the admission-to-treatment-time is the main task, as the prehospital phase (e.g. symptom-to-admission-interval) varies considerably and is hardly to be influenced. "Acute mesenteric ischaemia" should early be considered as a possible diagnosis in patients presenting with abdominal symptoms of unknown cause bearing risk-factors for intestinal ischaemic disorders. In such cases an immediate angiography is the method of choice to confirm the diagnosis. To avoid irreversible intestinal damage, immediate laparotomy is induced if competent conducted angiography is not available within one hour after suspicion of intestinal ischaemia.