Abdominal Vascular Catastrophes

Emerg Med Clin North Am. 2016 May;34(2):327-39. doi: 10.1016/j.emc.2015.12.014.

Abstract

Abdominal vascular catastrophes are among the most challenging and time sensitive for emergency practitioners to recognize. Mesenteric ischemia remains a highly lethal entity for which the history and physical examination can be misleading. Laboratory tests are often unhelpful, and appropriate imaging must be quickly obtained. A multidisciplinary approach is required to have a positive impact on mortality rates. Ruptured abdominal aortic aneurysm likewise may present in a cryptic fashion. A specific type of ruptured aneurysm, the aortoenteric fistula, often masquerades as the more common routine gastrointestinal bleed. The astute clinician recognizes that this is a more lethal variant of gastrointestinal hemorrhage.

Keywords: Aorto-enteric fistula; Gastrointestinal bleeding; Mesenteric ischemia; Ruptured abdominal aortic aneurysm.

Publication types

  • Review

MeSH terms

  • Aorta, Abdominal / pathology
  • Aortic Aneurysm, Abdominal* / diagnosis
  • Aortic Aneurysm, Abdominal* / etiology
  • Aortic Diseases* / diagnosis
  • Aortic Diseases* / etiology
  • Aortic Rupture / diagnosis
  • Aortic Rupture / etiology
  • Emergency Service, Hospital
  • Gastrointestinal Hemorrhage* / diagnosis
  • Gastrointestinal Hemorrhage* / etiology
  • Humans
  • Intestinal Fistula* / diagnosis
  • Intestinal Fistula* / etiology
  • Mesenteric Ischemia / diagnosis
  • Mesenteric Ischemia / etiology
  • Mesenteric Ischemia / physiopathology
  • Vascular Fistula* / diagnosis
  • Vascular Fistula* / etiology