Akute mesenteriale Durchblutungsstörungen.

Summary Subsets of acute mesenteric circulation disorders comprise mesenteric artery embolism and thrombosis, mesenterial vein thrombosis and non-occlusive mesenteric ischemia. Clinical presentation is often characterized by a discrepancy between severe subjective pain and relatively unspectacular findings on physical examination; all forms still carry an appallingly high mortalitiy rate. The most important point for better survival rates is early and, if indicated, invasive and aggressive diagnosis and treatment. Unfortunately, there are no non-invasive diagnostic tests of sufficient sensitivity and specificity so far, and mesenterial angiography (or abdominal CT, if mesenterial venous thrombosis is supected) remains the gold standard of diagnosis. With the introduction of new techniques (multidetector row CT), computed tomography may play a more important role in the future. In the obstructive forms of arterial mesenteric ischemia, the main therapeutic step after stabilization of the circulation remains an early laparotomy with embolectomy or revascularization and, if appropriate, resection of infarcted bowel. In patients with nonocclusive mesenteric ischemia, counteraction of mesenteric vasoconstriction is the main therapeutic principle. This review describes the different forms of acute mesenteric circulation disorders and gives an overview of the currently established and recommended forms of diagnosis and treatment. [ABSTRACT FROM AUTHOR]