Acute mesenteric ischemia remains a major cause of intra-abdominal catastrophe and mortality in the vascular patient population. Interruption or diminution of blood flow to the small intestine and right colon principally results from mechanical obstruction of the superior mesenteric artery (SMA) by embolus or thrombosis or from primary splanchnic vasoconstriction, a clinical entity known as nonocclusive mesenteric ischemia (NOMI).

It estimated that NOMI is the underlying cause in at least 20% to 30% of cases of acute mesenteric ischemia and, unfortunately, results in mortality in up to 70% of afflicted patients.<sup>2 Berger R.L., Byrne J.J. Intestinal gangrene associated with heart disease Surg Gynecol Obstet 1961 ;  113 : 522-529

Cliccare qui per andare alla sezione Riferimenti, 18 Jenson C.B., Smith G.A. A clinical study of 51 cases of mesenteric infarction Surgery 1956 ;  40 : 930-937

Cliccare qui per andare alla sezione Riferimenti, 30 Wilson G.S.M., Block J. Mesenteric vascular occlusion Arch Surg 1956 ;  73 : 330-345

Cliccare qui per andare alla sezione Riferimenti</sup> This dismal prognosis is usually attributed to difficulty in antemortem diagnosis and an incomplete understanding of its pathophysiologic mechanism. Furthermore, the clinical presentation of NOMI is frequently associated with other life-threatening disorders in patients sustained by advanced mechanical and pharmacologic life support. Liberal use of arteriography in patients suspected to have NOMI offers the best chance for early diagnosis and treatment prior to bowel infarction. The purpose of this article is to summarize the current knowledge of the pathophysiology of NOMI and discuss the diagnostic and treatment modalities that may enhance survival in these critically ill patients.