Vascular System, Protocol 3/3 — completing the Vascular System.
Cross-Reference Notice
Mesenteric ischemia (arterial embolic, arterial thrombotic, mesenteric venous thrombosis, and non-occlusive mesenteric ischemia/NOMI) has a full dedicated protocol in the GI & Hepatology System, reflecting its clinical presentation as an acute abdomen requiring integrated gastroenterology/general surgery/vascular surgery management.
See: Mesenteric Ischemia (GI & Hepatology System) for the complete protocol, covering:
- The four-mechanism classification (embolic, thrombotic, venous, NOMI) with distinguishing risk factors and typical clinical courses
- The "pain out of proportion to exam" diagnostic principle and why lactate is a late, unreliable early marker
- CT angiography as the imaging modality of choice, including the significance of pneumatosis intestinalis and portal venous gas
- Mechanism-specific management: embolectomy/thrombolysis for arterial embolic disease, endovascular revascularization for thrombotic disease, anticoagulation for venous thrombosis, and the vasopressor-selection dilemma specific to NOMI
- Second-look laparotomy as a damage-control strategy for equivocal bowel viability
Relevant cross-links from this Vascular System:
- Acute Limb Ischemia (this system) shares the same embolic-vs-thrombotic mechanistic framework, applied to a different vascular bed
- Ruptured AAA (this system) for the related aortic pathology spectrum, including the shared damage-control resuscitation principles
This completes the Vascular System (3/3 protocols, with Mesenteric Ischemia maintained as a single authoritative protocol in the GI & Hepatology System rather than duplicated here).