Evidence-based, cost-effective management of acute mesenteric ischemia: An algorithm of the Journal of Trauma and Acute Care Surgery Emergency General Surgery Algorithms working group

Sharon Adler; Walter L. Biffl; Jeffrey Weiss; Todd W. Costantini; José J. Diaz; Kenji Inaba; David H. Livingston; Lena M. Napolitano; Alí Salim; Robert J. Winchell; Raúl Coimbra

doi:10.1097/ta.0000000000004734

July 25, 2025Journal of Trauma and Acute Care SurgeryOpen Access

Evidence-based, cost-effective management of acute mesenteric ischemia: An algorithm of the Journal of Trauma and Acute Care Surgery Emergency General Surgery Algorithms working group

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Key Points

To present a standardized, evidence-based clinical algorithm developed by an expert working group to guide the diagnosis and multidisciplinary management of acute mesenteric ischemia in adult patients.
The Journal of Trauma and Acute Care Surgery Emergency General Surgery Algorithms working group synthesized peer-reviewed literature and expert consensus into an annotated clinical pathway.
The algorithm establishes a structured framework organized around the 'six Rs': Recognize, Resuscitate, Reflect, Revascularize, Resect, and Reevaluate.
Biphasic contrast-enhanced computed tomographic angiography is established as the diagnostic standard of care, avoiding delays from oral contrast administration.
Endovascular or open revascularization should generally precede surgical bowel resection, with initial resuscitation prioritizing volume restoration over vasopressors.
A structured second-look laparotomy or laparoscopy at 12 to 24 hours is recommended to reassess bowel viability following definitive revascularization.

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Implication

Clinical practice guideline outlines a six-step management algorithm for acute mesenteric ischemia in adults, highlighting early revascularization and targeted resection.

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Adler et al. (2025) studied this question.

synapsesocial.com/papers/69dabfa5a6045d71bfa3e0eb https://doi.org/10.1097/ta.0000000000004734

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Evidence-based, cost-effective management of acute mesenteric ischemia: An algorithm of the Journal of Trauma and Acute Care Surgery Emergency General Surgery Algorithms working group

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Evidence-based, cost-effective management of acute mesenteric ischemia: An algorithm of the Journal of Trauma and Acute Care Surgery Emergency General Surgery Algorithms working group

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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