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Bowel ischemia

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https://www.readbyqxmd.com/read/28827911/short-bowel-syndrome-an-uncommon-clinical-entity-and-a-therapeutic-challenge-our-experience-and-review-of-literature
#1
Lalit Aggarwal, Swati Sattavan, Romesh Lal, Deborshi Sharma, Saurabh Borgharia, Nishit Shrivastava, Rama Alagappan, Ranvir Singh
Short bowel syndrome (SBS), one of the commonest types of intestinal failure, usually secondary to extensive bowel resection, traditionally has been associated with a high mortality rate and hence a big challenge for the treating surgeons. It requires comprehensive clinical care to minimise the morbidities and mortality associated with the condition. We report a retrospective review of a series of seven patients with SBS, who presented at our surgical emergency within a period of 1 year and their outcome so as to encourage others in managing such a challenge with more positive mindsets...
August 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28822385/pneumatosis-intestinalis-in-patients-receiving-tube-feeds
#2
Alexander C Cavalea, Robert E Heidel, Brian J Daley, Christy M Lawson, Darrell A Benton, James M McLoughlin
Pneumatosis intestinalis (PI) identified on computed tomography (CT) suggests an underlying pathology including bowel ischemia. Patients receiving tube feeds can develop PI, potentially requiring surgical intervention. We identify clinical factors in PI to predict those that may be safe to observe versus those that need immediate intervention. We retrospectively reviewed patients from a single institution from 2008 to 2016 with CT findings of PI and an enteric feeding tube. Patients who had not received tube feeds within one week of the CT were excluded...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28817406/idiopathic-myointimal-hyperplasia-of-mesenteric-veins-an-uncommon-cause-of-ischemic-colitis-with-distinct-mucosal-features
#3
Rhonda K Yantiss, Isabelle Cui, Nicole C Panarelli, Jose Jessurun
Idiopathic myointimal hyperplasia of mesenteric veins causes chronic ischemic mucosal injury with segmental strictures that mimic inflammatory bowel disease and nonocclusive ischemic colitis. It is characterized by myointimal proliferative changes that narrow the lumina of veins combined with ischemic injury and ulcers. Most cases reported to date have been diagnosed following surgical resection. The aim of this study was to determine whether mucosal changes of idiopathic myointimal hyperplasia of mesenteric veins are sufficiently sensitive and specific to allow its recognition in biopsy material...
August 15, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28812000/diagnostic-imaging-features-of-necrotizing-enterocolitis-a-narrative-review
#4
REVIEW
Francesco Esposito, Rosanna Mamone, Marco Di Serafino, Carmela Mercogliano, Valerio Vitale, Gianfranco Vallone, Patrizia Oresta
Necrotizing enterocolitis (NEC) is an inflammatory process, characterized by intestinal necrosis of variable extension, leading to perforation, generalized peritonitis and death. The classical pathogenetic theory focuses on mucosal damage related to a stress induced intestinal ischemia leading to mucosal injury and bacterial colonization of the wall. A more recent hypothesis emphasizes the role of immaturity of gastrointestinal and immune system, particularly of the premature, responsible of bowel wall vulnerability and suffering...
June 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28811930/improved-ct-detection-of-acute-bowel-ischemia-using-frequency-selective-non-linear-image-blending
#5
Sven Schneeweiss, Michael Esser, Wolfgang Thaiss, Hans Boesmueller, Hendrik Ditt, Konstantin Nikolau, Marius Horger
BACKGROUND: Computed tomography (CT) as a fast and reliable diagnostic technique is the imaging modality of choice for acute bowel ischemia. However, diagnostic is often difficult mainly due to low attenuation differences between ischemic and perfused segments. PURPOSE: To compare the diagnostic efficacy of a new post-processing tool based on frequency selective non-linear blending with that of conventional linear contrast-enhanced CT (CECT) image blending for the detection of bowel ischemia...
July 2017: Acta Radiologica Open
https://www.readbyqxmd.com/read/28811810/what-is-done-when-endoscopic-examination-reveals-borderline-bowel-ischemia-in-patients-with-sigmoid-volvulus
#6
Sabri Selcuk Atamanalp, Refik Selim Atamanalp
Sigmoid volvulus (SV) is a rare colonic obstruction in which the sigmoid colonwraps around itself. The principal strategy for the treatment of uncomplicated SV is emergency endoscopic detorsion, while emergency surgery is needed in complicated SV with bowel gangrene, bowel perforation, peritonitis, or unsuccessful endoscopic treatment. In the endoscopic examination of SV, endoscopic detorsion is performed if the bowels are viable, while emergency surgery is needed if the bowels are gangrenous. However, the treatment approach is not clear when endoscopic examination reveals borderline bowel ischemia, and in this short report, the possible treatment strategies are discussed...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28797546/cell-free-deoxyribonucleic-acid-as-a-prognostic-marker-of-bowel-ischemia-in-patients-with-small-bowel-obstruction
#7
Uri Netz, Zvi Perry, Solly Mizrahi, Boris Kirshtein, David Czeiger, Gilbert Sebbag, Avraham Reshef, Amos Douvdevani
BACKGROUND: Patients with strangulation small bowel obstruction are at a high risk for serious morbidity and mortality due to ischemic bowel. Measuring serum, cell-free deoxyribonucleic acid levels could help recognize early cell death. Our hypothesis was that small bowel ischemia or necrosis is associated with increases in serum cell-free deoxyribonucleic acid and that recovery is associated with a decrease in cell-free deoxyribonucleic acid levels. METHODS: A prospective cohort study in addition to standard treatment of patients admitted with a diagnosis of small bowel obstruction...
August 7, 2017: Surgery
https://www.readbyqxmd.com/read/28794797/acute-mesenteric-ischemia-guidelines-of-the-world-society-of-emergency-surgery
#8
REVIEW
Miklosh Bala, Jeffry Kashuk, Ernest E Moore, Yoram Kluger, Walter Biffl, Carlos Augusto Gomes, Offir Ben-Ishay, Chen Rubinstein, Zsolt J Balogh, Ian Civil, Federico Coccolini, Ari Leppaniemi, Andrew Peitzman, Luca Ansaloni, Michael Sugrue, Massimo Sartelli, Salomone Di Saverio, Gustavo P Fraga, Fausto Catena
Acute mesenteric ischemia (AMI) is typically defined as a group of diseases characterized by an interruption of the blood supply to varying portions of the small intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process will eventuate in life threatening intestinal necrosis. The incidence is low, estimated at 0.09-0.2% of all acute surgical admissions. Therefore, although the entity is an uncommon cause of abdominal pain, diligence is always required because if untreated, mortality has consistently been reported in the range of 50%...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28791045/conservative-management-of-spontaneous-isolated-dissection-of-the-superior-mesenteric-artery
#9
Jae Hyun Kwon, Yoon Hee Han, Jun Kyu Lee
PURPOSE: We report the clinical outcomes of patients with spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) who were treated conservatively. MATERIALS AND METHODS: A retrospective review was performed in 14 patients from 2006 to 2016 with SIDSMA. Their clinical features and computed tomographic angiography (CTA) characteristics, treatment methods, and clinical outcomes were analyzed. The mean age was 53.6 (range, 41-73) years, and the mean follow-up duration was 20...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28780148/intra-abdominal-hypertension-abdominal-compartment-syndrome-and-the-open-abdomen
#10
REVIEW
William Kirke Rogers, Luis Garcia
Abdominal Compartment Syndrome (ACS) is the endpoint of a process whereby massive interstitial swelling in the abdomen or rapid development of a space-filling lesion within the abdomen (such as ascites or a hematoma) leads to a pathologically increased pressure. This results in so-called Intra-Abdominal Hypertension (IAH), causing decreased perfusion of the kidneys and abdominal viscera and possible difficulties with ventilation and maintenance of cardiac output. These effects contribute to a cascade of ischemia and multiple organ dysfunction with high mortality...
August 2, 2017: Chest
https://www.readbyqxmd.com/read/28777367/-antioxidant-anti-inflammatory-and-sedative-effects-of-melatonin-results-of-clinical-trials
#11
REVIEW
D I Burchakov, Yu B Uspenskaya
A literature review of clinical trials and systematic reviews on the antioxidant and anti-inflammatory effects of melatonin is presented. The results of animal studies and recent publications on the effects of melatonin in humans are summarized. Melatonin protects the cardiovascular system from destructive effects of ischemia/reperfusion, when the drug has been timely administered, has a neuroprotective effect in newborns with asphyxia. It is an effective drug in complex treatment of irritable bowel syndrome and inflammatory bowel diseases (Crohn's disease and ulcerative colitis)...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28764607/recycling-and-reinforcing-intimomedial-flap-of-the-infrarenal-aorta-using-anterior-longitudinal-ligament-in-patients-with-acute-trauma-with-bowel-injuries
#12
Milan Jovanovic, Milan Radojkovic, Predrag Djordjevic, Dejan Rancic, Nemanja Jovanovic, Zoran Rancic
We present a patient with blunt abdominal trauma with severe acute right limb ischemia and clinical signs of diffuse peritonitis. Computed tomography angiography showed circumferential dissection of the infrarenal aorta with occlusion of the right common iliac artery. We opted for simultaneous abdomen exploration and open repair of injured aorta. Critical weakening of the aortic wall with imminent rupture was identified intraoperatively. Aortotomy cranially from bifurcation showed circumferential intimomedial dissection...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28761871/the-usefulness-of-intraoperative-colonic-irrigation-and-primary-anastomosis-in-patients-requiring-a-left-colon-resection
#13
Youngki Hong, Soomin Nam, Jung Gu Kang
PURPOSE: The aim of this study is to assess the short-term outcome of intraoperative colonic irrigation and primary anastomosis and to suggest the usefulness of the procedure when a preoperative mechanical bowel preparation is inappropriate. METHODS: This retrospective study included 38 consecutive patients (19 male patients) who underwent intraoperative colonic irrigation and primary anastomosis for left colon disease between January 2010 and December 2016. The medical records of the patients were reviewed to evaluate the patients' characteristics, operative data, and postoperative short-term outcomes...
June 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28752257/what-is-the-best-revascularization-strategy-for-acute-occlusive-arterial-mesenteric-ischemia-systematic-review-and-meta-analysis
#14
Giancarlo Salsano, Antonio Salsano, Elena Sportelli, Francesco Petrocelli, M'ahmed Dahmane, Giovanni Spinella, Bianca Pane, Simone Mambrini, Domenico Palombo, Francesco Santini
PURPOSE: Acute mesenteric ischemia (AMI) is a life-threatening disease that leads to bowel infarction and death. The optimal management of AMI remains controversial. The present meta-analysis aimed to estimate the prognostic impact of surgical (SG) versus endovascular or hybrid intervention (EV) as the first-line treatment for acute arterial occlusive mesenteric ischemia and to assess whether endovascular strategy was actually effective in reducing bowel resection. METHODS: MEDLINE, Scopus and the Cochrane Library databases were searched...
July 27, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28739466/total-endovascular-treatment-of-acute-non-a-non-b-dissection-complicated-by-visceral-malperfusion-without-primary-entry-tear-coverage
#15
Raphael J Soler, Michel A Bartoli, Gaetan Simonet, Philippe Amabile, Gabrielle Sarlon-Bartoli, Pierre-Edouard Magnan
Management of visceral ischemia due to non-A, non-B dissection is extremely challenging due to the position of the primary entry tear at the level of the brachiocephalic vessels. We report on a patient who was admitted for a complicated non-A, non-B-type dissection with visceral and leg ischemia. A covered stent graft was implanted below the primary entry tear to redirect the flow in the true lumen, associated with stents implantation in the visceral arteries, to treat the dissection's static component. The patient did well, without need for bowel resection visceral or late stent restenosis...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28735976/predictive-value-of-procalcitonin-for-intestinal-ischemia-and-or-necrosis-in-pediatric-patients-with-adhesive-small-bowel-obstruction-asbo
#16
Eduardo Bracho-Blanchet, Alfredo Dominguez-Muñoz, Emilio Fernandez-Portilla, Cristian Zalles-Vidal, Roberto Davila-Perez
PURPOSE: Evaluate serum procalcitonin (PCT) level as a predictor of intestinal ischemia or necrosis (IN) in patients with postoperative adhesive small bowel obstruction (ASBO). METHODS: Prospective cohort of consecutive patients with ASBO. Patients previously treated with antibiotics or septic were excluded. PCT was measured at the diagnosis of ASBO and every 24 h afterwards. MAIN OUTCOME: intestinal ischemia or necrosis (IN). RESULTS: Fifty-nine patients were included, 12 of whom were excluded; 47 patients remained in the study; male-to-female ratio = 1...
July 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28730138/ileal-perforation-with-norovirus-gastroenteritis-in-a-3-month-old-infant
#17
Seol Woo Wi, Su Jin Lee, Eun Kyeong Kang, Sung Min Cho
Noroviruses have been recognized as the leading cause of epidemic and sporadic gastroenteritis since the advent of molecular diagnostic technique. They have been documented in 5-31% of pediatric patients hospitalized with gastroenteritis. Although norovirus gastroenteritis is typically mild and self-limited, it causes severe, but sometimes fatal, conditions in the vulnerable population such as immunocompromised patients, young children, and the elderly. Bowel perforation due to norovirus infection is rare. We report a case of small bowel perforation with norovirus gastroenteritis in the infant with Down syndrome during the hospitalization with pneumonia...
June 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28724276/fatal-small-intestinal-ischemia-due-to-methamphetamine-intoxication-report-of-a-case-with-autopsy-results
#18
Hamid Attaran
Methamphetamine is one of the most common abused drugs, so its various effects on different body organs should be familiar to all physicians. Regarding its gastrointestinal sequels, there are few reports of ischemic colitis induced by its vasoconstrictive effects. This is the first report of isolated small intestinal infarction resulting in death following methamphetamine toxicity. A 40-year-old woman with a past history of medical treatment for obesity referred to hospital with severe chest and back pain, perspiration, nausea, agitation, high blood pressure, bradycardia and subsequent lethargy and vasomotor instability...
May 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28712193/autoimmune-disease-presenting-as-acute-abdomen
#19
Wasim A Memon, Saad Siddiqui, Ameer Hamza
Mesenteric vasculitis and resultant bowel ischemia is rare but serious complication of autoimmune disorders. Early detection and treatment is the key to avoid potentially fatal outcomes of bowel perforation and peritonitis. In this series, we present patients presenting with acute abdominal pain and having CT imaging features of bowel ischemia who responded well to immunosuppressive therapy. The aim of this work is to familiarize health professionals with possibility and imaging features of mesenteric vasculitis...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28710988/intestinal-fatty-acid-binding-protein-level-as-a-predictor-of-28-day-mortality-and-bowel-ischemia-in-patients-with-septic-shock-a-preliminary-study
#20
Motohiro Sekino, Hiroyuki Funaoka, Shuntaro Sato, Kyoko Okada, Haruka Inoue, Rintaro Yano, Sojiro Matsumoto, Taiga Ichinomiya, Ushio Higashijima, Shuhei Matsumoto, Tetsuya Hara
PURPOSE: We sought to evaluate the levels of intestinal fatty acid-binding protein (I-FABP), a biomarker of enterocyte injury, as a predictor of 28-day mortality and bowel ischemia in septic shock patients. MATERIAL AND METHODS: In this preliminary prospective observational study, 57 adult septic shock patients under mechanical ventilation were enrolled. Serum I-FABP levels and prognostic biomarkers were recorded upon intensive care unit (ICU) admission. RESULTS: The overall 28-day mortality rate of participants was 23% (13/57)...
July 6, 2017: Journal of Critical Care
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