Duplex US evaluation of mesenteric vessels in acute abdomen. Prospective study on 325 patients

Acute Mesenteric Insufficiency (AMI) is a surgical emergency with a difficult methodological approach. Its high mortality is mainly due to delay in the correct diagnosis. In turn this is due to the lack of specificity of the clinical presentation and of the laboratory data and abdominal radiographic findings, especially in the early-middle phase. To evaluate the positive predictive value (PPV) and negative predictive value (NPV) of Duplex Ultrasound (DU) of mesenteric vessels in the diagnosis of acute mesenteric ischaemia. 325 patients were prospective analyzed with Duplex US (Aloka ssd 1700); 120 with acute abdomen (group A); 120 healthy subjects without abdomen preparation (group B); 85 healthy subjects with abdomen preparation (group C). We considered the B mode visualization, the vessel extension and diameter, the colour signal capture (enhancement), the velocitograms with systolic peak velocity and medium diastolic velocity. In 32 patients with high suspect of AMI we founded 21 really negative results, 3 wrong positive results, 5 really positive results, 3 false negative results. The PPV and NPV were respectively 0.62 and 0.87. The Duplex Us is more useful rather exclude than confirm AMI.