Techniques for intraoperative evaluation of bowel viability in mesenteric ischemia: A review

Acute mesenteric ischemia (AMI) is a deadly and common surgical emergency. While several imaging modalities aid in the diagnosis of AMI preoperatively, there are limited intraoperative tools for surgeon decision making regarding bowel viability. Here we offer a review of the utility and limitations of the many extensively studied techniques. We classify each of these modalities into three hallmarks of healthy bowel: oxygenation, myoelectric activity and perfusion. Finally, we offer a brief discussion of emerging and promising techniques to assist surgeons in intraoperative decision making for patients with mesenteric ischemia.