The impact of early diagnostic laparoscopy on the prognosis of patients with suspected acute mesenteric ischemia

Purpose To assess the impact of early diagnostic laparoscopy in patients with suspected acute mesenteric ischemia in whom other diagnostic studies are inconclusive or unavailable. Methods The medical records of patients who underwent diagnostic laparoscopy with a preoperative diagnosis of acute mesenteric ischemia between January 2008 and January 2012 were reviewed. The patients who had a preoperative diagnosis of acute mesenteric ischemia based on computed tomography or angiography were excluded. Outcome variables were the time between admission and diagnostic laparoscopy, overall revascularization rate, successful revascularization rate, and in-hospital mortality rate. Results Fifty-three patients were included in the study. Twelve patients (22.6 %) had negative diagnostic laparoscopy. In 43 patients (77.4 %) who were found to have acute mesenteric ischemia at diagnostic laparoscopy, the mean time between admission and diagnostic laparoscopy, overall revascularization rate, successful revascularization rate, and in-hospital mortality rate were 10.2 h, 32.5 %, 13.9 %, and 74.4 %, respectively. The mean time between admission and diagnostic laparoscopy was significantly shorter in patients who underwent successful revascularization, and in those who survived with or without developing short bowel syndrome. Conclusions Diagnostic laparoscopy is a safe and reliable diagnostic tool that can have a positive impact on the prognosis of patients with suspected acute mesenteric ischemia if carried out in a timely manner when radiological diagnostic studies are inconclusive or unavailable.