Sharma A, et al. - The clinical features and outcomes of patients with gastric ischemia were highlighted in this study. Gastric ischemia was correlated with significant mortality, although it was uncommon. An important role was performed by endoscopy and CT imaging in its diagnosis. The management of gastric ischemia was dictated by its severity and associated comorbidities.

Methods

• From January 1, 2000, to May 5, 2016, the researchers performed a retrospective review of patients diagnosed with isolated gastric ischemia at their institution.
• They abstracted demographic, clinical, endoscopic, radiologic, and outcome variables for analysis.

Results

• The researchers identified 17 patients (65% men) with mean age of 69.3 ± 11.3 years and body mass index of 28.8 ± 11.1.
• Local vascular causes (n = 8), systemic hypoperfusion (n = 4), and mechanical obstruction (n = 5) were included as the etiologies for gastric ischemia.
• Abdominal pain (65%), gastrointestinal bleeding (47%), and altered mental status (23%) were the most common presenting symptoms.
• Mucosal congestion and erythema with or without ulceration was the typical endoscopic appearance.
• On CT imaging, gastric pneumatosis and portal venous air were more commonly observed.
• In 9 patients, radiologic and/or surgical intervention was needed, whereas the remaining 8 patients were managed conservatively with acid suppression, antibiotics, and nasogastric tube decompression.
• The median duration of hospital stay was 15 days (range 1-36 days).
• No cases of rebleeding were reported.
• As a direct result of gastric ischemia, the mortality rate was 24% within 6 months of diagnosis.