Current approaches to diagnosis and management of Acute Mesenteric Ischaemia – a scoping review

Introduction: Acute mesenteric ischaemia (AMI) is a life-threatening condition with mortality exceeding 50%. This scoping review evaluates current diagnostic and management strategies, comparing endovascular and open surgical approaches. Methods: Following Arksey and O’Malley’s framework, a systematic search was conducted in OVID MEDLINE, EMBASE, and Web of Science (2005–2024). English-language studies on AMI were included. Data on diagnostic methods, mortality, hospital/ICU stay, and surgical outcomes were extracted. Results: Thirty-nine studies (20,991 patients) were analysed. CT was the primary diagnostic tool, with diagnosis delays ranging from 13.9–48 hours. Endovascular interventions demonstrated lower 30-day mortality (0%–53.8%) versus open surgery (21%–81%). Hospital (5–15.35 vs. 5.7–27.26 days) and ICU stays (0–5.35 vs. 2–13 days) were shorter with endovascular management. Bowel resection and re-laparotomy rates were also reduced. Conclusion: Endovascular management is associated with improved outcomes, including reduced mortality and shorter hospital stays. Timely diagnosis and patient selection remain critical. A multidisciplinary approach is essential, though further prospective studies are needed to standardise protocols.