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Bowel ischemia

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https://www.readbyqxmd.com/read/28073669/reoperation-rates-after-open-and-endovascular-abdominal-aortic-aneurysm-repairs
#1
Conor F Hynes, Kendal M Endicott, Sina Iranmanesh, Richard L Amdur, Robyn Macsata
OBJECTIVE: This study compared reoperation rates associated with open abdominal aortic aneurysm (AAA) repair (OR) outcomes vs endovascular AAA repair (EVAR). METHODS: A retrospective review of the Veterans Affairs Surgical Quality Improvement Project data was performed with inclusion criteria defined as all patients who underwent AAA repair from October 1, 2007, to October 1, 2013. The primary outcome was the incidence of reoperations. Reoperations included subsequent OR or EVAR procedures performed on the abdominal aorta or iliac arteries, surgical treatment of temporally related bowel obstruction, as well as treatment of abdominal or groin wound complications ≤6 months and treatment of bowel or lower limb ischemia ≤10 days...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28060943/farnesoid-x-receptor-activation-attenuates-intestinal-ischemia-reperfusion-injury-in-rats
#2
Laurens J Ceulemans, Len Verbeke, Jean-Paul Decuypere, Ricard Farré, Gert De Hertogh, Kaatje Lenaerts, Ina Jochmans, Diethard Monbaliu, Frederik Nevens, Jan Tack, Wim Laleman, Jacques Pirenne
INTRODUCTION: The farnesoid X receptor (FXR) is abundantly expressed in the ileum, where it exerts an enteroprotective role as a key regulator of intestinal innate immunity and homeostasis, as shown in pre-clinical models of inflammatory bowel disease. Since intestinal ischemia reperfusion injury (IRI) is characterized by hyperpermeability, bacterial translocation and inflammation, we aimed to investigate, for the first time, if the FXR-agonist obeticholic acid (OCA) could attenuate intestinal ischemia reperfusion injury...
2017: PloS One
https://www.readbyqxmd.com/read/28043313/ogilvie-s-syndrome
#3
Muhammad Waqas Khan, Sanniya Khan Ghauri, Sara Shamim
Ogilvie's syndrome, also known as 'paralytic ileus of the colon', is characterised by pseudo-obstruction of the large intestine in the absence of any mechanical obstructing component; and presents as a massively distended abdomen. If left untreated, it may lead to bowel perforation or ischemia. Ogilvie's syndrome usually presents as a postsurgical complication, mainly due to the lack and/or restriction of movement coupled with a possible electrolyte imbalance. Here, we present a case of a pre-surgical 63-year lady, having a right hip fracture, who came with complaints of severe abdominal pain and distension for 4 days...
December 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28042560/inferior-mesentery-artery-and-internal-iliac-artery-preservation-with-covered-self-expanding-stents-during-endovascular-aneurysm-repair
#4
Yun Gyu Song, Hong Jang, Hyun Oh Park, Seong Ho Moon, Jong Woo Kim, Sung Hwan Kim, Jun Ho Yang, Joung Hun Byun
We report an endovascular aneurysm repair in a patient with isolated bilateral common iliac artery aneurysms, a prominent inferior mesentery artery (IMA), and bilateral proximal internal iliac artery (IIA) aneurysms using covered self-expanding stents to preserve the IMA and bilateral internal iliac arteries. A follow-up computed tomography angiography was obtained at 1 month. Pelvic circulation was well preserved without bowel ischemia. IMA and bilateral IIA preservation with covered self-expanding stents during endovascular aneurysm repair is a safe and effective method...
December 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/28033740/intestinal-malrotation-and-replaced-common-hepatic-artery-during-duodenopancreatectomy-a-case-report
#5
Alexander Schank, Philippe Colonval, Mikhaël Salame
BACKGROUND: Intestinal malrotation is a well-known anomaly in the normal rotation process of the midgut during embryogenesis. Multiple forms are described, resulting in various positional configurations of the small bowel and colon. Replaced common hepatic artery is a rare but not anecdotic variant of the standard hepatic vascularization, associated with surgical implications. Our aim is to explain the impact of their simultaneous presence during this procedure and the difficulty in identifying them preoperatively, despite imaging...
December 29, 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28009224/mesenteric-ischemia-following-the-correction-of-adult-spinal-deformity-case-report
#6
Krishn Khanna, Sigurd H Berven
Vascular complications are an important adverse event that can be associated with spinal reconstructive surgery. Direct injury of vessels, or indirect traction or compression of vessels, can cause both arterial and venous injury. Indirect compression of the mesenteric vessels is a well-recognized complication of bracing and surgical care of children with spinal deformity (superior mesenteric artery syndrome), but the complication is not common or well recognized in the adult population with spinal deformity...
December 23, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28003918/superior-mesenteric-artery-syndrome-with-abdominal-compartment-syndrome
#7
Kevin Reece, Rachel Day, Janna Welch
Superior Mesenteric Artery (SMA) syndrome is a condition in which the duodenum becomes compressed between the SMA and the aorta, resulting in bowel obstruction which subsequently compresses surrounding structures. Pressure on the inferior vena cava (IVC) and aorta decreases cardiac output which compromises distal blood flow, resulting in abdominal compartment syndrome with ischemia and renal failure. A 15-year-old male with SMA syndrome presented with 12 hours of pain, a distended, rigid abdomen, mottled skin below the waist, and decreased motor and sensory function in the lower extremities...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27986486/one-year-pivotal-trial-outcomes-of-the-nellix-system-for-endovascular-aneurysm-sealing
#8
Jeffrey P Carpenter, Robert Cuff, Clifford Buckley, Christopher Healey, Sajjad Hussain, Michel M P J Reijnen, Jose Trani, Dittmar Böckler
OBJECTIVE: The Nellix EndoVascular Aneurysm Sealing (EVAS) System (Endologix, Inc, Irvine, Calif) is a novel approach to abdominal aortic aneurysm (AAA) treatment whereby polymer is used to fill the AAA sac. We report 1-year results of the investigational device exemption pivotal trial. METHODS: Eligible patients were treated at 30 sites in the United States and Europe. Inclusion criteria required an asymptomatic infrarenal AAA, with a neck length ≥10 mm and ≤60° angle, iliac artery blood lumen diameter 9 to 35 mm, access artery diameter ≥6 mm, and serum creatinine ≤2 mg/dL...
December 13, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27986479/prospective-nonrandomized-study-to-evaluate-endovascular-repair-of-pararenal-and-thoracoabdominal-aortic-aneurysms-using-fenestrated-branched-endografts-based-on-supraceliac-sealing-zones
#9
Gustavo S Oderich, Mauricio Ribeiro, Jan Hofer, Jean Wigham, Stephen Cha, Julia Chini, Thanila A Macedo, Peter Gloviczki
PURPOSE: To investigate outcomes of manufactured fenestrated and branched endovascular aortic repair (F-BEVAR) endografts based on supraceliac sealing zones to treat pararenal aortic aneurysms and thoracoabdominal aortic aneurysms (TAAAs). METHODS: A total of 127 patients (91 male, mean age 75 ± 10 years old) were enrolled in a prospective, nonrandomized single-center study using manufactured F-BEVAR (November 2013-March 2015). Stent design was based on supraceliac sealing zone in all patients with ≥ four vessels in 111 (89%)...
December 13, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27974095/occlusive-vasculopathy-in-human-immunodeficiency-virus-hiv-associated-vasculitis-unusual-clinical-and-imaging-course
#10
Enric Ripoll, Sergio Prieto-González, Olga Balagué, Javier Marco-Hernández, Josep M Miró, Anna Darnell, Maria C Cid, José Hernández-Rodríguez
Human immunodeficiency virus (HIV)-associated vasculitis is a rare secondary systemic vasculitis involving medium and small arteries. We report a 42-year-old man with uncontrolled HIV infection presenting with long-lasting abdominal pain. An abdominal CT angiography revealed multiple microaneurysms and stenoses in intrarenal arteries, with involvement of mesenteric and hepatic arteries. HIV-associated vasculitis was diagnosed and glucocorticoids and raltegravir-based antiretroviral therapy were administered with good initial clinical and virological response...
December 14, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27928685/laparoscopic-deloyers-procedure-for-tension-free-anastomosis-after-extended-left-colectomy-technique-and-results
#11
A Sciuto, C Grifasi, F Pirozzi, P Leon, R E M Pirozzi, F Corcione
BACKGROUND: The Deloyers procedure, which includes inversion of the right colon around the axis of the ileocolic vessels, can be used to achieve a well vascularized, tension-free colorectal anastomosis after extended left colectomy. The aim of this study is to report our technique and outcome in a series of ten consecutive patients who underwent right colonic transposition by laparoscopic approach. METHODS: Charts were retrospectively reviewed to analyze postoperative outcome and bowel function...
December 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27923206/delayed-intestinal-stenosis-of-nonocclusive-mesenteric-ischemia-after-autologous-blood-collection-a-case-report
#12
Takahiro Arima, Takashi Omura, Koji Hattori, Ken Kawamoto, Yuji Koba
INTRODUCTION: Nonocclusive mesenteric ischemia (NOMI) has been reported to be associated with high mortality. Early diagnosis of NOMI and prompt restoration of the intestinal blood flow is necessary in order to achieve a favorable outcome. PRESENTATION OF CASE: We present the case of a patient who developed NOMI after autologous blood collection and was treated by selective infusion of the superior mesenteric artery with papaverine, intestinal decompression using a long intestinal tube, the administration of antibiotics, and fluid replacement...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27921277/surgery-for-acute-exacerbation-of-chronic-mesenteric-ischemia-a-case-report
#13
Shinji Abe, Tomoji Yamakawa, Hideaki Kawashima, Makoto Yoshida, Setsuji Takanashi, Motoya Kashiyama, Masahiro Ishigooka, Yasushige Shingu, Yoshiro Matsui
BACKGROUND: Chronic mesenteric ischemia (CMI) is a rare disease; however, symptomatic CMI has a risk of acute exacerbation without timely revascularization. CASE PRESENTATION: A 54-year-old man who had had postprandial pain for 6 months was admitted to our hospital because of vomiting and diarrhea. Although the celiac and superior mesenteric arteries were occluded at the proximal portion, contrast enhancement of the bowel wall was good in contrast-enhanced computed tomography (CECT)...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27897305/-cervical-ischaemic-neuronopathy-and-cardioembolism-another-cause-of-man-in-the-barrel-syndrome
#14
H Gonzalez-Usigli, A Gandarilla, J J Garcia, J Serrato, N Estrada
INTRODUCTION: Spinal infarction accounts for 1% of all strokes. Cardioembolism is a rare cause. Common areas of ischemic spinal damage are watershed in the dorsal or lumbar regions; however cervical spinal cord infarction has been reported previously. CASE REPORT: We present a new case of a man-in-the-barrel syndrome produced by cardiac embolization associated with atrial fibrillation during an acute myocardial infarction, which caused cervical ischemic neuronopathy (infarction of the anterior horn)...
December 16, 2016: Revista de Neurologia
https://www.readbyqxmd.com/read/27894424/intestinal-rotation-abnormalities-and-midgut-volvulus
#15
REVIEW
Jacob C Langer
Rotation abnormalities may be asymptomatic or may be associated with obstruction caused by bands, midgut volvulus, or associated atresia or web. The most important goal of clinicians is to determine whether the patient has midgut volvulus with intestinal ischemia, in which case an emergency laparotomy should be done. If the patient is not acutely ill, the next goal is to determine whether the patient has a narrow-based small bowel mesentery. In general, the outcomes for children with a rotation abnormality are excellent, unless there has been midgut volvulus with significant intestinal ischemia...
February 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27888039/total-midgut-volvulus-in-adults-with-intestinal-malrotation-report-of-eleven-patients
#16
H Kotobi, V Tan, J Lefèvre, F Duramé, G Audry, Y Parc
OBJECTIVE: Total small-intestinal volvulus with malrotation (TSIVM) classically presents in the neonatal period; it occurs much less frequently in the adult and is often misdiagnosed. Prognosis is directly related to the degree and duration of intestinal ischemia. Our goal is to describe our experience with TSIVM in the adult, to identify any specific findings and to discuss its management. METHOD: Eleven patients who had undergone surgery for TSIVM at three centers between 1992 and 2012 were included...
November 22, 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/27885390/ct-angiography-in-the-setting-of-suspected-acute-mesenteric-ischemia-prevalence-of-ischemic-and-alternative-diagnoses
#17
Frank Oliver Henes, Perry J Pickhardt, Andrzej Herzyk, Scott J Lee, Utaroh Motosugi, Thorsten Derlin, Meghan G Lubner, Gerhard Adam, Gerhard Schön, Peter Bannas
PURPOSE: The purpose of the study was to determine the prevalence of ischemic and alternative diagnoses and the diagnostic accuracy of CT angiography (CTA) in the setting of suspected acute mesenteric ischemia (AMI). MATERIAL AND METHODS: We included 959 patients undergoing CTA for the evaluation of suspected AMI. The final clinical diagnosis was used to determine the prevalence of ischemic and alternative diagnoses and to calculate the diagnostic accuracy of CTA...
November 24, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27870784/intussusception-with-cecal-cyst-as-lead-point-in-a-child
#18
Michelle Lai, Brian A Coakley, Eric M Webber, Ran D Goldman
Intussusception is a pediatric abdominal emergency in early childhood involving telescoping of 1 part of the bowel into another part. In most children, the condition is idiopathic with no identifiable lead point. Meckel diverticulum is the most common lead point, followed by polyps and duplication cysts. We describe a case of a boy with intussusception caused by a duplication cyst that was drawn retrograde through the ileocecal valve. The patient presented after a 3-month period of symptomatology and had been considered to have constipation before signs of intestinal obstruction developed...
November 19, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27858375/diagnosis-of-non-occlusive-acute-mesenteric-ischemia-in-the-intensive-care-unit
#19
Simon Bourcier, Ammar Oudjit, Geoffrey Goudard, Julien Charpentier, Sarah Leblanc, Romain Coriat, Hervé Gouya, Bertrand Dousset, Jean-Paul Mira, Frédéric Pène
BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is a common complication and accounts for a major cause of death in critically ill patients. The diagnosis of NOMI with respect to the eventual indications for surgical treatment is challenging. We addressed the performance of the diagnostic strategy of NOMI in the intensive care unit, with emphasis on contrast-enhanced abdominal CT-scan. METHODS: This was a retrospective monocenter study. Patients with clinically suspected acute mesenteric ischemia were included if a comprehensive diagnostic workup was carried out including surgical and/or endoscopic digestive explorations...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27857460/ct-manifestations-of-small-bowel-ischemia-due-to-impaired-venous-drainage-with-a-correlation-of-pathologic-findings
#20
Chung Kuao Chou
Acute abdominal pain may result from a wide variety of medical and surgical diseases. One of these diseases is small bowel ischemia, which may result in a catastrophic outcome if not recognized and treated promptly. Computed tomography (CT) by its faster image acquisition, thinner collimation, high resolution, and multiplanar reformatted images has become the most important imaging modality in evaluating the acute abdominal conditions. In this article, the author presents a description of the histology of the small bowel, pathophysiology of small bowel change, and a correlation of the pathologic and CT findings of the small bowel injuries due to impaired venous drainage...
July 2016: Indian Journal of Radiology & Imaging
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