Non-occlusive mesenteric ischemia in critically ill patients: does bedside laparoscopy offer any real benefit?

Abstract

Non-occlusive mesenteric ischemia in critically ill patients still has a poor prognosis. Despite several established risk factors, the interaction between clinical conditions and perfusion mismatch often leads to progressive organ failure. Workup is challenging because of the absence of typical abdominal signs and symptoms due to sedation, poor reactivity, need for ventilation, and confounding comorbidities. Moreover, imaging has poor specificity with findings often inconclusive. A bedside exploratory laparoscopy, as a complementary strategy, would allow for early and prompt diagnosis. Limits of a minimally invasive surgical rationale lie upon the effects of pneumoperitoneum induction, surgical stress, logistical resources, expertise, and costs.

Keywords

Acute abdomen / Intensive care unit / Laparoscopy / Non-occlusive mesenteric ischemia

Conflict of interest statement

The authors declare no conflict of interest.

Author contributions

Barone M, Frontera R, and Liouras RV contributed to the concept. Barone M, Serano L, Iovino CG, Ippoliti M contributed to the de-sign. Mucilli F, Vetrugno L, and Maggiore SM contributed to the supervision. Barone M, Frontera R, Liouras RV, Serano L contrib-uted to materials. Barone M, Serano L, Ippoliti M collected and processed data. Barone M and Frontera R contributed to analysis and/or interpretation. Frontera R, Liouras RV, Iovino CG, and Ippoliti M contributed to literature search. All authors wrote and re-viewed the manuscript.

Funding

None.

Ethical approval of studies and informed consent

Not applicable.

Acknowledgments

None.

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