Overview
Gastrointestinal mucosal necrosis refers to the death of mucosal tissue within the gastrointestinal tract, often seen in severe inflammatory conditions, ischemia, or trauma, leading to potential complications such as perforation and peritonitis. 1Diagnosis
Clinical presentation includes severe abdominal pain, tenderness, and signs of peritonitis.
Imaging studies (CT, MRI) are crucial for identifying necrosis and assessing extent of involvement.
Endoscopy may be diagnostic, showing characteristic necrotic areas, though risky in unstable patients.
Laboratory markers like elevated white blood cell count and inflammatory markers support the diagnosis. 1Management
Surgical intervention: Urgent resection of necrotic tissue and repair of any perforations is often necessary. 1
Prophylactic negative-pressure wound therapy (pNPWT): Associated with reduced surgical site infection rates in emergency lower gastrointestinal surgery. 1
Antibiotics: Broad-spectrum coverage to prevent or manage infections, tailored based on clinical suspicion and local resistance patterns.
Supportive care: Fluid resuscitation, hemodynamic stabilization, and intensive care monitoring are essential. 1Special Populations
No specific data provided in the abstracts regarding pregnancy, pediatrics, elderly, or comorbidities related to gastrointestinal mucosal necrosis management. 1Key Recommendations
Utilize prophylactic negative-pressure wound therapy (pNPWT) in patients undergoing emergency lower gastrointestinal surgery to reduce surgical site infection rates. (Evidence: Moderate) 1
Perform urgent surgical intervention for gastrointestinal mucosal necrosis to remove necrotic tissue and repair perforations. (Evidence: Expert opinion) 1
Implement broad-spectrum antibiotic therapy tailored to clinical context to prevent or manage infections post-surgery. (Evidence: Expert opinion) 1References
1 Imaizumi K, Kasajima H, Terashima K, Furukawa N, Ito K, Fukasawa T et al.. Prophylactic negative-pressure wound therapy using the open method is associated with reduced surgical site infection after emergency lower gastrointestinal surgery: A retrospective cohort study with propensity score analyses. Medicine 2025. link