Newswise — Early detection of mesenteric ischemia increases treatment options and the possibility of a full recovery, but the condition’s rarity may lead to a delay in diagnosis while more common causes of abdominal pain are explored.

An article in the February 2018 issue of Critical Care Nurse (CCN) aims to heighten nurses’ knowledge of mesenteric ischemia and infarction (MI), which are infrequent but often deadly conditions in acute and critically ill patients, with a mortality rate of 50 to 60 percent.

By considering the uncommon diagnosis in patient assessment and evaluation, nurses can help identify patients at risk more quickly so appropriate diagnostics and interventions may ensue. 

MI: Not a Heart Attack but a Gut Attack” discusses the different types of arterial and venous MI of the small bowel, focusing on the vascular causes of the condition. The article reviews risk factors, clinical presentations, diagnostics and collaborative interventions.

MI symptoms may mimic more common gastrointestinal issues, including irritable bowel syndrome, appendicitis, ulcers, colon cancer or abdominal aortic aneurysm. It’s necessary to first evaluate patients for these unrelated conditions and rule them out, as appropriate, even though these similarities can lead to delays in diagnosis.  

With acute MI due to a thrombus, patients may appear to have unstable angina, or a similar experience before a myocardial infarction or heart attack.

Another type of acute MI is due to an embolus, and patients may present with nausea, vomiting and severe abdominal pain that is out of proportion to the physical findings. The abdomen may be soft with present bowel sounds, leading clinicians to evaluate other causes of the pain.

One of the hallmark signs of chronic MI is intestinal angina, with many patients reporting cramps or other pain and discomfort that begin soon after eating and subside within a few hours.

Rosemary K. Lee, DNP, ARNP, ACNP-BC, CCRN, CCNS, and Ana M. Cabrera, DNP, ARNP, ACNP-BC, CCRN, co-wrote the article. Lee is a clinical nurse specialist for critical and progressive care at Homestead Hospital in Florida, and Cabrera serves as Homestead’s assistant vice president for critical and progressive care, obstetric, emergency and surgical services.  

“Looking at only the most common causes for complications can lead to a delay in diagnosis, which can be deadly in cases of mesenteric ischemia,” Lee said. “Time is of the essence for these patients, and nurses with a high level of suspicion can look beyond the often vague and confusing symptoms.”

As the American Association of Critical-Care Nurses bimonthly clinical practice journal for high-acuity, progressive and critical care nurses, CCN is a trusted source of information related to the bedside care of critically and acutely ill patients.

Access the article abstract and full-text PDF by visiting the CCN website at http://ccn.aacnjournals.org.

 

About Critical Care Nurse: Critical Care Nurse (CCN), a bimonthly clinical practice journal published by the American Association of Critical-Care Nurses, provides current, relevant and useful information about the bedside care of critically and acutely ill patients. The award-winning journal also offers columns on traditional and emerging issues across the spectrum of critical care, keeping critical care nurses informed on topics that affect their practice in high-acuity, progressive and critical care settings. CCN enjoys a circulation of more than 114,000 and can be accessed at http://ccn.aacnjournals.org/.

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than half a million acute and critical care nurses and includes more than 200 chapters in the United States. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution.

American Association of Critical-Care Nurses, 101 Columbia, Aliso Viejo, CA 92656-4109; 949-362-2000; www.aacn.org; facebook.com/aacnface; twitter.com/aacnme

 

 

SEE ORIGINAL STUDY