Delayed Diagnosis of AMI: A Time-Critical Emergency Often Missed
At Lupetin & Unatin, LLC, we represent individuals and families harmed by delays in diagnosing serious medical emergencies. One of the most devastating of these is acute mesenteric ischemia (AMI)—a condition where blood flow to the intestines is suddenly reduced or cut off, leading to irreversible damage within hours if not treated.
Despite advances in imaging and critical care, AMI remains frequently misdiagnosed or recognized too late, often because its early symptoms can appear nonspecific or mimic more benign conditions. When diagnosis is delayed, the consequences are life-threatening – and often preventable.
What Is Acute Mesenteric Ischemia?
Acute mesenteric ischemia is a life-threatening condition that occurs when blood flow to the small intestine (and sometimes the large intestine) is reduced or blocked. The loss of blood deprives the intestinal tissue of oxygen, leading to bowel necrosis, perforation, sepsis, and potentially death if not promptly reversed.
AMI strikes suddenly and requires immediate medical or surgical intervention.
Types of Acute Mesenteric Ischemia
There are four main types of AMI, all of which can be fatal if not diagnosed and treated urgently:
- Arterial Embolism – A blood clot (often from the heart) travels to and blocks the superior mesenteric artery (SMA), a major artery that supplies blood to the intestines
- Arterial Thrombosis – A clot forms inside a narrowed, diseased artery (typically the SMA)
- Non-Occlusive Mesenteric Ischemia (NOMI) – A low-flow state (e.g., shock, heart failure) reduces blood supply without an actual blockage
- Mesenteric Venous Thrombosis – A clot forms in the mesenteric veins, preventing blood from draining properly
Each type requires a different treatment approach, but the key to survival in all cases is early detection.
Early Warning Signs: When Doctors Should Suspect AMI
The classic early symptom of AMI is severe abdominal pain out of proportion to physical findings—meaning the pain is much worse than what the exam would suggest. Other early signs include:
- Nausea, vomiting, or diarrhea (sometimes with blood)
- Abdominal distension or tenderness
- Rapid heart rate, low blood pressure, or signs of shock
- Metabolic acidosis or elevated lactate levels
- CT findings suggestive of vascular compromise or bowel injury
When these signs appear—especially in older adults or those with cardiovascular disease—doctors are expected to act quickly to rule out mesenteric ischemia.
Who Is at Risk for AMI?
Doctors should be alert to AMI in patients who have:
- Atrial fibrillation or a history of cardiac embolism
- Recent heart attack, heart failure, or low-flow states
- Sepsis, hypotension, or massive blood loss
- Vascular disease or atherosclerosis
- End-stage renal disease or hemodialysis
- Hypercoagulable conditions (e.g., cancer, clotting disorders)
- Recent abdominal surgery or vasoactive medication use
These risk factors should raise red flags and prompt early CT angiography, lab testing, and surgical or vascular consultation.
Where Medical Mistakes Happen
Unfortunately, patients with AMI are often misdiagnosed in the early hours of their illness. Common clinical errors include:
- Attributing symptoms to gastritis, constipation, or gastroenteritis
- Failing to order urgent imaging, particularly CT angiography
- Misinterpreting radiology findings or failing to follow up on suspicious results
- Delaying surgical consultation in critically ill patients
- Failing to recognize NOMI in ICU or post-operative patients
These mistakes are especially dangerous because intestinal tissue can become irreversibly damaged within 3–6 hours. Every minute matters.
What Happens When Diagnosis Is Missed?
When the diagnosis of AMI is delayed, the following complications may occur:
- Bowel infarction (dead intestine), requiring massive resection, or removal of bowel
- Short bowel syndrome, with lifelong dependence on intravenous nutrition
- Perforation, sepsis, and multi-organ failure
- Death, often within 24–48 hours of symptom onset
In many cases, a timely diagnosis and intervention could have prevented these outcomes.
How Lupetin & Unatin Can Help
At Lupetin & Unatin, LLC, we investigate potential medical malpractice involving delayed or missed diagnosis of acute mesenteric ischemia. Our legal team works with highly qualified medical experts—including gastroenterologists, surgeons, emergency physicians, and radiologists—to determine whether doctors and hospitals failed to follow the standard of care.
We:
- Review complete medical records, imaging studies, and communication records like texts and portal messages with health care providers;
- Consult with board-certified medical specialists
- Build a detailed timeline of care and missed opportunities
- Show how earlier diagnosis and treatment could have changed the outcome
If we determine that medical negligence played a role in your injury—or in the death of your loved one—we fight to hold those responsible accountable and recover compensation for your losses.
Real-Life Cases of Delayed Diagnosis of AMI
Several jury verdicts and settlements have confirmed the serious harm caused by delayed recognition of mesenteric ischemia:
$4.7 million verdict (Ohio): Radiologist failed to identify SMA occlusion on CT.
$5.5 million verdict (Connecticut): ER failed to diagnose until too late; patient died.
$12.8 million verdict (Missouri): Patient discharged without proper imaging; developed short bowel syndrome.
$8.2 million verdict (Missouri): Delayed surgery caused permanent dependence on IV nutrition.
$1.9 million settlement (confidential): Patient sent home, returned with ischemic bowel, and died.
Learn more about SMA occlusion, the most common cause of AMI: Delayed Diagnosis of Superior Mesenteric Artery (SMA) Occlusion
Contact Us Today
If you or a loved one suffered serious harm—or died—because doctors failed to diagnose or treat acute mesenteric ischemia in time, we’re here to help.
Call Lupetin & Unatin, LLC today or fill out our online form for a free case evaluation. We represent clients throughout Pittsburgh and Pennsylvania, and we’re committed to uncovering the truth and seeking justice for victims of medical negligence.