Canadian Association of General Surgeons and American College of Surgeons Evidence Based Reviews in Surgery. 15 Biphasic computed tomography with mesenteric evaluation of acute mesenteric ischemia

Question: Is biphasic computed tomography (CT) with mesenteric CT angiography effective in diagnosing acute mesenteric ischemia (AMI)? Design: Prospective cohort study. Setting: Two tertiary care centres in Canada. Patients: Sixty-two patients had clinically suspected AMI, with a finding of abdominal pain and at least 1 of the following symptoms: pain out of proportion to clinical findings; biochemical evidence of ischemia, namely, elevated lactate levels or unexpected metabolic acidosis; or patients’ risk factors for ischemia, such as previous ischemia or symptoms of chronic ischemia, severe vascular disease, atrial fibrillation without therapeutic anticoagulation, low flow (history of hypotension or vasopressor therapy) or hypercoagulable states. The patients consisted of 21 men (age range 32–87 [mean 60] yr) and 41 women (age range 32–87 [mean 65] yr). All patients were examined before CT angiography by a specialist (either a general or vascular surgeon or an internist). Description Correspondence to: Ms. Marg McKenzie, RN, Administrative Assistant, CAGS-EBRS, Mount Sinai Hospital, 1560-600 University Ave., Toronto ON M5G 1X5; fax 416 586-5932; [email protected] Evidence-Based Surgery Chirurgie factuelle Canadian Association of General Surgeons and American College of Surgeons Evidence Based Reviews in Surgery. 15 Biphasic computed tomography with mesenteric evaluation of acute mesenteric ischemia Robin McLeod, MD; Thomas Lindsay, MD; Martin O’Malley, MD; for Members of the Evidence Based Reviews in Surgery Group* *The CAGS Evidence Based Reviews in Surgery Group comprises Drs. J.S.T. Barkun, K. Brasel, G.W.N. Fitzgerald, H.J.A. Henteleff, A.W. Kirkpatrick, S. Latosinsky, H.M. MacRae, R.S. McLeod, L.A. Neumayer, D. Rogers, M.C. Taylor, E.M. Webber and