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Bowel ischemia

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https://www.readbyqxmd.com/read/29033516/primary-endovascular-intervention-for-acute-mesenteric-ischemia-performed-by-interventional-cardiologists-a-single-center-experience
#1
Tsung-Yan Chen, Chih-Horng Wu, Wen-Feng Hsu, Lin Lin, Ren-Huei Wang, Chao-Lun Lai, Kuei-Chin Tsai, Li-Ta Keng, Chih-Cheng Wu, Mu-Yang Hsieh
The current standard care for acute mesenteric ischemia (AMEI) involves urgent revascularization and resection of the necrotic bowel. Since 2012, we have used an AMEI protocol of our own design, which focused on early treatment and allowed interventional cardiologists to become involved when interventional radiologist was not available. A total of 8 patients were treated, and two interventional cardiologists performed all the stenting procedures. The procedure success rate was 100% in patients with non-calcified lesions (6/8)...
July 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28986677/split-bolus-single-scan-cta-for-evaluation-of-mesenteric-ischemia
#2
Patricia C Jo, Fernanda C Cabral, Azize Sahin, Andrés Camacho, Alexander Brook, Olga R Brook
PURPOSE: To evaluate split-bolus single scan CTA protocol for evaluation of acute mesenteric ischemia. MATERIALS AND METHODS: In this HIPAA-compliant IRB-approved study, consecutive patients evaluated for mesenteric ischemia between 11/2015 and 10/2016 were included. Patients scanned prior to 4/2016 were scanned with multiphasic CTA protocol and after with split-bolus single scan CTA. Objective and subjective evaluation was performed by three board-certified readers...
October 6, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28972809/non-occlusive-mesenteric-ischemia-ct-findings-clinical-outcomes-and-assessment-of-the-diameter-of-the-superior-mesenteric-artery
#3
Carlos Pérez-García, Enrique de Miguel Campos, Adriana Fernández Gonzalo, Carlos Malfaz, Jesus Martín Pinacho, Carmen Fernández Álvarez, Raquel Herranz Pérez
OBJECTIVE: Review of the experience of a tertiary care centre for almost 10 years in the CT diagnosis of non-occlusive mesenteric ischemia (NOMI). Analysis of CT findings, correlation with clinical outcomes and evaluation of the usefulness of measuring the superior mesenteric artery (SMA) diameter for the diagnosis of NOMI. METHODS: 106 patients were diagnosed with NOMI in a biphasic CT examination from 2008 to 2017 in our hospital. Clinical outcomes and CT findings were reviewed...
October 3, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28963604/understanding-the-weekend-effect-for-emergency-general-surgery
#4
Richard S Hoehn, Derek E Go, Vikrom K Dhar, Young Kim, Dennis J Hanseman, Koffi Wima, Shimul A Shah
BACKGROUND: Several studies have identified a "weekend effect" for surgical outcomes, but definitions vary and the cause is unclear. Our aim was to better characterize the weekend effect for emergency general surgery using mortality as a primary endpoint. METHODS: Using data from the University HealthSystem Consortium from 2009 to 2013, we identified urgent/emergent hospital admissions for seven procedures representing 80% of the national burden of emergency general surgery...
September 29, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28956274/successful-treatment-of-non-occlusive-mesenteric-ischemia-with-indocyanine-green-fluorescence-and-open-abdomen-management
#5
Toshiyuki Irie, Takeshi Matsutani, Nobutoshi Hagiwara, Tsutomu Nomura, Itsuo Fujita, Yoshikazu Kanazawa, Daisuke Kakinuma, Eiji Uchida
Non-occlusive mesenteric ischemia (NOMI), which can lead to multifocal and segmental intestinal necrosis without demonstrable occlusion in the main mesenteric artery, is associated with extremely high mortality. Because these intestinal ischemic changes can progress, it is difficult to make a definitive determination intraoperatively as to whether resection of damaged intestine is required. A 62-year-old man who underwent esophagectomy for advanced cervicothoracic esophageal cancer complained of severe abdominal pain on postoperative day 4...
September 27, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28955699/effect-of-clinical-suspicion-by-referral-physician-and-early-outcomes-in-patients-with-acute-superior-mesenteric-artery-embolism
#6
Hyung-Kee Kim, Deokbi Hwang, Sujin Park, Seung Huh, Jong-Min Lee, Woo-Sung Yun, Young-Wook Kim
PURPOSE: To investigate the pattern of referral of patients with superior mesenteric artery embolism (SMAE) and its effect on outcomes, and to evaluate the risk factors for bowel infarction. MATERIALS AND METHODS: This retrospective study included 66 consecutive patients diagnosed with acute SMAE between January 2001 and June 2016. Appropriate diagnosis by the referring physician was defined if the referral letter indicated that acute mesenteric ischemia was suspected or had been diagnosed at the referral center...
September 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28933137/rectal-perforation-in-a-42-year-old-woman-due-to-henoch-sch%C3%A3-nlein-purpura-a-case-report
#7
F Almassinokiani, A Mehdizadeh Kashi, A Musavi, S Khodaverdi, K Tahermanesh, S Ariana
Henoch-Schönlein purpura (HSP) is caused by deposition of IgA-containing immune complexes within the blood vessels. HSP mostly occurs in children and is less common in adults. In addition to palpable purpura, arthritis or arthralgia, renal disease and abdominal pain, gastrointestinal symptoms occur in 50% of children. These can be caused by gastrointestinal hemorrhage, bowel ischemia and necrosis, intussusception, and bowel perforation. In adults, intussusception is less frequent than in children. We report a 42-year-old woman referred to our hospital with acute abdominal pain...
September 21, 2017: Reumatismo
https://www.readbyqxmd.com/read/28932257/a-novel-method-for-multiple-bowel-injuries-a-pilot-canine-experiment
#8
Jun Ke, Weihang Wu, Nan Lin, Weijin Yang, Zhicong Cai, Wei Wu, Dongsheng Chen, Yu Wang
BACKGROUND: Intestinal ligation is the cornerstone for damage control in abdominal emergency, yet it may lead to bowel ischemia. Although intestinal ligation avoids further peritoneal cavity pollution, it may lead to an increased pressure within the bowel segments and rapid bacterial translocation. In this study, we showed that severed intestine could be readily reconnected by using silicon tubes and be secured by using rubber bands in a canine model. METHODS: Adult Beagle dogs, subject to multiple intestinal transections and hemorrhagic shock by exsanguination, randomly received conventional ligation vs...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28920023/re-tubularization-of-highly-ischemic-anti-mesenteric-border-rehab-a-novel-bowel-preservation-technique-in-complex-gastroschisis
#9
Richard J Hendrickson, Ashwini S Poola, Katherine W Gonzalez, Joel Lim, Tolulope A Oyetunji
Complex gastroschisis with bowel necrosis poses an operative challenge. Surgeons must weigh the decision between resection versus preservation of ischemic bowel. As one of the leading causes of short bowel syndrome, aggressive resection in complicated gastroschisis subjects children to prolonged dependence on parenteral nutrition and its attendant complications. Herein, we describe a novel technique aimed towards bowel preservation in complex gastroschisis patients with severe bowel ischemia with the ultimate goal for enteral autonomy...
July 2017: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/28912083/nasogastric-decompression-not-associated-with-a-reduction-in-surgery-or-bowel-ischemia-for-acute-small-bowel-obstruction
#10
Daniel J Berman, Hamza Ijaz, Mohammad Alkhunaizi, Paige E Kulie, Khashayar Vaziri, Lorna M Richards, Andrew C Meltzer
OBJECTIVES: Small bowel obstructions (SBOs) occur 300,000 times annually leading to $1.3 billion in cost. Approximately 20% of patients require a laparotomy to manage the obstruction and either prevent or treat intestinal ischemia. Early management may play a role in reducing these complications. Nasogastric decompression is commonly used for early management. Our primary objective was to determine if NGD was associated with lower rates of surgery, bowel ischemia or length of stay. METHODS: We retrospectively enrolled 181 ED patients with SBO from 9/2013 to 9/2015 in order to determine if nasogastric decompression was associated with a reduction in rates of surgery, bowel ischemia or hospital length of stay...
August 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28906389/risk-factor-analysis-for-nonocclusive-mesenteric-ischemia-following-cardiac-surgery-a-case-control-study
#11
Ju Yong Lim, Joon Bum Kim, Sung Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
Although rare, postcardiac surgery nonocclusive mesenteric ischemia (NOMI) is a life-threatening condition. Identifying the risk factors for NOMI during immediate postoperative period may help early detection and intervention, which leads to improved clinical outcomes. The objective of this study was to identify the clinical features and risk factors of NOMI for prognosis identification after cardiac surgery, focusing on immediate postoperative parameters.Among 9445 patients who underwent cardiac surgery over a span of 9 years, 40 NOMI cases (0...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28903385/dpp-4-enzyme-deficiency-protects-kidney-from-acute-ischemia-reperfusion-injury-role-for-remote-intermittent-bowel-ischemia-reperfusion-preconditioning
#12
Yen-Ta Chen, Christopher Glenn Wallace, Chih-Chao Yang, Chih-Hung Chen, Kuan-Hung Chen, Pei-Hsun Sung, Yung-Lung Chen, Han-Tan Chai, Sheng-Ying Chung, Sarah Chua, Fan-Yen Lee, Sheung-Fat Ko, Mel S Lee, Hon-Kan Yip
We analyzed the effects of acute ischemia-reperfusion (KIR) injury on the status of kidney function and architecture in dipeptidyl peptidase4-difficient (DPP4(D)) rats and the effect of remote small bowel ischemia-reperfusion (BIR) preconditioning. DPP4-deficient (DPP4(D)) and normal Fischer344 (F344) rats were divided into 6 groups: (1) sham-F344, (2) sham-DPP4(D), (3) KIR-F344 (4) KIR-DPP4(D), (5) DPP4(D)-KIR-extendin-9-39 and (6) BIR-KIR-F344. Blood creatinine and urea nitrogen levels and the urinary protein-to-creatinine ratio was higher in KIR-F344 rats than BIR-KIR-F344 or KIR-DPP4(D) rats 72 h after acute KIR...
August 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28892784/ileal-angiodysplasia-presentation-as-a-bowel-obstruction-a-case-report
#13
Ons Ghdes, Ali Gaja, Ahlem Blel, Hichem Jarraya, Najla Mnif
INTRODUCTION: Angiodysplasia is a common vascular abnormality of the gastrointestinal tract, found in the elderly and most frequently revealed by gastrointestinal bleeding. We report an original case of ileal angiodysplasia in an 83-year-old woman presenting as a bowel obstruction. CASE PRESENTATION: An 83-year-old woman with a medical history of chronic untreated anemia, presented with cardinal symptoms of bowel obstruction. Computed tomography revealed diffuse ileal wall thickening with multiple zones of stenosis, which were aggravated by an ileal perforation and associated with vascular abnormalities compatible with angiodysplasia...
July 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28879575/in-hospital-mortality-for-hepatic-portal-venous-gas-analysis-of-1590-patients-using-a-japanese-national-inpatient-database
#14
Chie Koizumi, Nobuaki Michihata, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Hepatic portal venous gas (HPVG) is rare but potentially serious condition. Main cause of HPVG is bowel ischemia, while detection of HPVG without bowel ischemia may have been increasing possibly due to widespread use of computed tomography. However, little is known about variation in etiologies of HPVG and mortality of HPVG with each etiology. We examined patient backgrounds, underlying diseases, and in-hospital mortality of HPVG patients using a national inpatient database...
September 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28877534/open-abdomen-improves-survival-in-patients-with-peritonitis-secondary-to-acute-superior-mesenteric-artery-occlusion
#15
Weiwei Ding, Kai Wang, Baochen Liu, Xinxin Fan, Shikai Wang, Jianmin Cao, Xingjiang Wu, Jieshou Li
BACKGROUND: Damage control surgery and open abdomen (OA) have been extensively used in the severe traumatic patients. However, there was little information when extended to a nontrauma setting. The purpose of this study was to evaluate whether the liberal use of OA as a damage control surgery adjunct improved the clinical outcome in acute superior mesenteric artery occlusion patients. STUDY DESIGN: A single-center, retrospective cohort review was performed in a national tertiary surgical referral center...
October 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28874089/outcome-of-surgeon-modified-fenestrated-branched-stent-grafts-for-symptomatic-complex-aortic-pathologies-or-contained-rupture
#16
Nikolaos Tsilimparis, Franziska Heidemann, Fiona Rohlffs, Holger Diener, Sabine Wipper, E Sebastian Debus, Tilo Kölbel
PURPOSE: To analyze the outcome of surgeon-modified fenestrated and branched stent-grafts (sm-FBSG) in high-risk patients with symptomatic complex aortic pathology or contained rupture. METHODS: A single-center retrospective analysis was conducted of 21 consecutive patients (mean age 70 years, range 58-87; 16 men) treated with a sm-FBSG from April 2014 to September 2016. The indications included 11 thoracoabdominal and 10 pararenal aortic pathologies, which presented as symptomatic in 8 and as contained rupture in 13 patients...
September 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28868231/laser-speckle-contrast-imaging-to-evaluate-bowel-lesions-in-neonates-with-nec
#17
Kristine Bach Korsholm Knudsen, Joergen Thorup, Rune Broni Strandby, Rikard Ambrus, Linea Landgrebe Ring, Inge Ifaoui
Background  Necrotizing enterocolitis (NEC) is the most frequent surgical emergency in newborns. Intestinal ischemia is considered a factor that precedes the development of NEC lesions. Laser speckle contrast imaging (LSCI) can be used to assess tissue microcirculation. We evaluated if LSCI may help to detect intestinal regions with reduced microcirculation in NEC. Case Report  A male patient (gestational age, 26 [3/7] weeks; birth weight, 600 g) showed clinical signs of NEC 28 days after birth. X-ray revealed pneumatosis intestinalis and portal gas...
January 2017: European Journal of Pediatric Surgery Reports
https://www.readbyqxmd.com/read/28845108/the-role-of-endovascular-therapy-in-acute-mesenteric-ischemia
#18
Anna Maria Ierardi, Dimitrios Tsetis, Sara Sbaraini, Salvatore Alessio Angileri, Nikolaos Galanakis, Mario Petrillo, Francesca Patella, Silvia Panella, Federica Balestra, Natalie Lucchina, Gianpaolo Carrafiello
BACKGROUND: Endovascular therapy, including aspiration thrombectomy and local thrombolytic therapy, often associated with angioplasty and stent placement, has been described in the literature. The purpose of this study was to review case series of patients with acute mesenteric ischemia treated with endovascular therapy and evaluate their outcomes. METHODS: An online review using PubMed was carried out to identify all English articles about this topic in the time interval from 2005 to 2016...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28842393/e6130-a-novel-cx3c-chemokine-receptor-1-cx3cr1-modulator-attenuates-mucosal-inflammation-and-reduces-cx3cr1-leukocyte-trafficking-in-mice-with-colitis
#19
Hisashi Wakita, Tatsuya Yanagawa, Yoshikazu Kuboi, Toshio Imai
The chemokine fractalkine (CX3C chemokine ligand 1; CX3CL1) and its receptor CX3CR1 are involved in the pathogenesis of several diseases, including inflammatory bowel diseases such as Crohn's disease and ulcerative colitis, rheumatoid arthritis, hepatitis, myositis, multiple sclerosis, renal ischemia, and atherosclerosis. There are no orally available agents that modulate the fractalkine/CX3CR1 axis. [(3S,4R)-1-[2-Chloro-6-(trifluoromethyl)benzyl]-3-{[1-(cyclohex-1-en-1-ylmethyl)piperidin-4-yl]carbamoyl}-4-methylpyrrolidin-3-yl]acetic acid (2S)-hydroxy(phenyl)acetate (E6130) is an orally available highly selective modulator of CX3CR1 that may be effective for treatment of inflammatory bowel disease...
November 2017: Molecular Pharmacology
https://www.readbyqxmd.com/read/28841570/diagnosis-biomarkers-in-acute-intestinal-ischemic-injury-so-close-yet-so-far
#20
REVIEW
Katell Peoc'h, Alexandre Nuzzo, Kevin Guedj, Catherine Paugam, Olivier Corcos
Acute intestinal ischemic injury (i3) is a life-threatening condition with disastrous prognosis, which is currently difficult to diagnose at the early stages of the disease; a rapid diagnosis is mandatory to avoid irreversible ischemia, extensive bowel resection, sepsis and death. The overlapping protein expression of liver and gut related to the complex physiopathology of the disease, the heterogeneity of the disease and its relative rarity could explain the lack of a useful early biochemical marker of i3...
August 25, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
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