Acute Mesenteric Ischaemia Presenting With Gangrenous Bowel: A Retrospective Observational Study From a Tertiary Care Centre in Northern India

IntroductionAcute mesenteric ischaemia (AMI) is a surgical emergency with high case fatality.Institutional outcome data describing the clinical, radiological, operative, and histopathological characteristics of AMI presenting with gangrenous bowel from tertiary care hospitals in Northern India are lacking. MethodologyWe conducted a retrospective observational study of 18 patients who presented with AMI resulting in gangrenous bowel at our institution between April 2023 and April 2026 (36 months).Clinicopathological data, operative details, histopathological findings, and outcomes were retrospectively retrieved and analysed. ResultsThe median age was 62 years (range, 38-79); 15 patients were male (83.3%).Superior mesenteric artery (SMA) thrombosis was the predominant aetiology (10 patients; 55.6%).CT angiography was performed in all patients, with findings consistent with AMI in every included patient.All patients underwent emergency exploratory laparotomy; the median length of resected bowel was 120 cm (range, 60-250 cm).Ten patients (55.6%) died during hospital admission; the leading causes were septic shock and multi-organ dysfunction syndrome (MODS).The median hospital stay among survivors was 18 days (range, 12-31 days).Histopathological examination confirmed transmural coagulative necrosis in all resected specimens. ConclusionsAMI presenting with gangrenous bowel was associated with substantial in-hospital mortality (55.6%) in this cohort.The findings describe the clinical characteristics, operative management, and in-hospital outcomes of patients presenting with advanced disease in a resource-constrained setting.