Acute Mesenteric Ischemia (AMI) and Infarction
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First Things First (assess & treat the following):
- Early diagnosis is the key to management; hence, the diagnosis should be suspected on clinical ground based on a high degree of suspicion.
- Look for prodromal symptoms (i.e., recent MI or arrhythmia, PE or DVT, postprandial abdominal pain, etc.).
- Examine the abdomen
- Key words: “Pain out of proportion”
- If abdomen is acute with peritonitis (delayed presentation), patient does not require any more work-ups. Patient needs to go to the OR after volume resuscitation.
- Make sure patient is volume resuscitated: will need Foley, IV access, etc.
- Four different varieties: acute artery embolic, acute artery thrombosis, acute venous thrombosis, or a low flow state (non-occlusive)