Publication:

Acute mesenteric artery occlusion in hypobaric oxygen environment

Background Acute mesenteric ischemia represents a challenge in Taif and related districts where hypobaric oxygen may add to other risk factors as prevalence of diabetes mellitus and obesity. The aim of this retrospective study was to record and discuss the underlying risk factors, pattern of presentation, methods of diagnosis and results of treatment of acute mesenteric ischemia in Taif Tertiary Hospitals.

Methods In this chart review and database study, thirty-one patients met the inclusion criteria in the period from January 2009 to December 2017. The outcomes included demographics, risk factors, clinical findings, diagnostic and therapeutic methods, in addition to the mortality and follow up of the study population.

Results The commonest presenting symptom was abdominal pain (100%), of them 45.2% had marked peritoneal signs.  Diagnosis was established by CT angiography in 41.9% and after exploratory laparotomy in 58.1% of patients. Mesenteric artery thrombosis was the cause in 64.5% and embolism in 35.5%. In all patient’s necrotic bowel segments were resected followed by revascularization. Reoperation was performed in 32.3% of patients. Perioperative deaths were 41.9% and the overall mortality 58.1%.

Conclusions The findings of this study are not quite different from that performed on population living in normobaric oxygen environment except for a higher incidence of arterial thrombosis. Validation of these findings needs more standardized large prospective studies to avoid the impact of different confounding factors and the limited statistical power related to small sample sizes.