Gastroenterology

Gastroenterology

Volume 118, Issue 5, May 2000, Pages 951-953
Gastroenterology

American Gastroenterological Association
American Gastroenterological Association medical position statement: Guidelines on intestinal ischemia

https://doi.org/10.1016/S0016-5085(00)70182-XGet rights and content

Abstract

This document presents the official recommendations of the American Gastroenterological Association (AGA) on intestinal ischemia. It was approved by the Clinical Practice and Practice Economics Committee on September 25, 1999, and by the AGA Governing Board on November 15, 1999.

GASTROENTEROLOGY 2000;118:951-953

Section snippets

Acute mesenteric ischemia: Algorithm 1

Algorithm 1. (A and B) Diagnosis and treatment of intestinal ischemia. Solid lines indicate accepted management plan; dashed lines indicate alternate management plan. DVT, deep vein thrombosis; SMA, superior mesenteric artery.

Acute mesenteric ischemia (AMI) can result from emboli, arterial and venous thrombi, or vasoconstriction secondary to low flow. Mortality rates reported over the last 15 years remain as high as they did more than 70 years ago and average 71%, with a range of 59%–93%.

Chronic mesenteric ischemia: Algorithm 2

Algorithm 2. Management of CMI. Solid lines indicate accepted management plan; dashed lines indicate alternate management plan. MRA, magnetic resonance angiography; CT, computerized tomography.

Chronic mesenteric ischemia (CMI; “intestinal angina”) is characterized by postprandial abdominal pain and marked weight loss and is caused by repeated transient episodes of inadequate intestinal blood flow, usually provoked by the increased metabolic demands associated with digestion. Because

Colon ischemia: Algorithm 3

Algorithm 3. Management of colon ischemia. Solid lines indicate accepted management plan; dashed lines indicate alternate management plan. BE, barium enema; NPO, nothing by mouth; IV, intravenous; PLC, protein-losing colopathy; IBD, inflammatory bowel disease.

Colon ischemia (CI) is the most common form of intestinal ischemia and comprises a spectrum of disorders: (1) reversible colopathy, (2) transient colitis, (3) chronic colitis, (4) stricture, (5) gangrene, and (6) fulminant universal

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Address requests for reprints to: Chair, Clinical Practice and Practice Economics Committee, AGA National Office, c/o Membership Department, 7910 Woodmont Avenue, 7th Floor, Bethesda, Maryland 20814. Fax: (301) 654-5920.

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