Acute mesenteric ischemia. Possibilities of early diagnostics. Literature review

The article is devoted to the urgent problem of early diagnosis of acute mesenteric ischemia (AMI), which is characterized by high lethality (50–80 %) and difficulty of timely detection. The main causes of AMI development are: Arterial occlusion (embolism, thrombosis); Venous thrombosis; Non-occlusive ischemia. The key risk factors are: Cardiovascular diseases; Blood coagulation disorders. It is fundamentally important to detect pathology as early as possible - in the first 6 hours from the onset of the disease, when the probability of a favorable outcome is 70–80 %. The article details the clinical manifestations of OMI, laboratory markers and instrumental methods of diagnosis. The clinical picture is characterized by a gradual increase in symptoms: from moderate abdominal pain to the development of peritonitis. The peculiarity is the absence of pathognomonic signs, which significantly complicates timely diagnosis. Special attention is paid to CT-angiography as the most informative method of visualization with sensitivity 85–98 % and specificity 91–100 %. Modern approaches to the interpretation of laboratory parameters such as leukocyte count, lactate and D-dimer levels are presented. Despite significant advances in modern medicine, the lethality of AMI remains high and reaches 50–80 %, which emphasizes the need for continuous improvement of diagnostic and therapeutic approaches.