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Bowel ischemia

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https://www.readbyqxmd.com/read/29682371/colonic-mucosal-ulceration-and-gastrointestinal-bleeding-associated-with-sevelamer-crystal-deposition-in-a-patient-with-end-stage-renal-disease
#1
Sudheer Nambiar, Unnikrishnan Kunjan Pillai, Joe Devasahayam, Tony Oliver, Asha Karippot
End stage renal disease (ESRD) population account for 1.9 per patient year of hospital admissions annually. ESRD population are at increased risk of bleeding secondary to use of anticoagulation during hemodialysis and uremia induced platelet dysfunction. Gastrointestinal bleeding accounts for 3-7% of all deaths in ESRD population. Lower gastrointestinal bleeding refers to blood loss from a site in the gastrointestinal tract distal to the ligament of Treitz. It is usually suspected when a patient complains of hematochezia...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29679213/increased-unenhanced-bowel-wall-attenuation-a-specific-sign-of-bowel-necrosis-in-closed-loop-small-bowel-obstruction
#2
Camille Rondenet, Ingrid Millet, Lucie Corno, Isabelle Boulay-Coletta, Patrice Taourel, Marc Zins
OBJECTIVES: To identify computed tomography (CT) findings associated with bowel necrosis in patients with surgically confirmed strangulating closed-loop small-bowel obstruction (CL-SBO) due to adhesions or internal hernia. METHODS: This retrospective study was approved by our institutional review board, and informed consent was waived. To identify CT signs of bowel necrosis, two gastrointestinal radiologists performed blinded, independent, retrospective reviews of 41 CT studies from consecutive patients who had CL-SBO due to adhesions or internal hernias and who underwent surgery within 48 h...
April 20, 2018: European Radiology
https://www.readbyqxmd.com/read/29673298/initial-clinical-experience-using-the-low-profile-altura-endograft-system-with-double-d-shaped-proximal-stents-for-endovascular-aneurysm-repair
#3
Dainis Krievins, Albrecht Krämer, Janis Savlovskis, Georgij Oszkinis, E Sebastian Debus, Alexander Oberhuber, Christopher K Zarins
PURPOSE: To report the initial clinical results of endovascular aneurysm repair (EVAR) using the low-profile (14-F) Altura Endograft System, which features a double "D-shaped" stent design with suprarenal fixation and modular iliac components that are deployed from distal to proximal. METHODS: From 2011 to 2015, 90 patients (mean age 72.8±8.3 years; 79 men) with abdominal aortic aneurysm (AAA; mean diameter 53.8±5.7 mm) were treated at 10 clinical sites in 2 prospective, controlled clinical studies using the Altura endograft...
April 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29671149/biological-scoring-system-for-early-prediction-of-acute-bowel-ischemia-after-cardiac-surgery-the-palm-score
#4
Elie Zogheib, Cyril Cosse, Charles Sabbagh, Simon Marx, Thierry Caus, Marc Henry, Joseph Nader, Mathurin Fumery, Michael Bernasinski, Patricia Besserve, Faouzi Trojette, Cedric Renard, Pierre Duhaut, Said Kamel, Jean-Marc Regimbeau, Hervé Dupont
BACKGROUND: Bowel ischemia is a life-threatening emergency defined as an inadequate vascular perfusion leading to bowel inflammation resulting from impaired colonic/small bowel blood supply. Main issue for physicians regarding bowel ischemia diagnosis lies in the absence of informative and specific clinical or biological signs leading to delayed management, resulting in a poorer prognosis, especially after cardiac surgery. The aim of the present series was to propose a simple scoring system based on biological data for the diagnosis of bowel ischemia...
April 18, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29649954/anatomical-considerations-and-open-surgery-to-treat-juxtarenal-abdominal-aortic-aneurysms
#5
Georgiana Samoila, Ian Michael Williams
INTRODUCTION: Historically, the open approach to the abdominal aorta has been transperitoneal (TP). In comparison, a retroperitoneal (RP) incision exposes the lateral wall of the suprarenal aorta for clamp application and midline structures such as the duodenum and pancreas are not encountered. Proximal clamp position for open repair of juxtarenal abdominal aortic aneurysm (JR-AAA) is suprarenal, supra-superior mesenteric, or supraceliac. While RP and TP approaches have previously been compared for physiological reasons, there are currently no randomized controlled trials comparing these methods from an anatomical perspective...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29649951/biliary-ascariasis-presenting-with-gangrenous-perforation-of-the-gall-bladder-report-of-a-case-and-brief-review-of-literature
#6
Ankush Sharma, Priyansh Jariwala, Navneet Kaur
The most common cause of gallbladder perforation is calculous cholecystitis. Rarer causes include trauma, iatrogenic injuries, biliary stasis and gall bladder ischemia. We report a case of gall bladder gangrene with perforation, secondary to extensive ascariasis. A 45-year-old woman presented with acute intestinal obstruction and jaundice. She had abdominal distension and right hypochondrial tenderness. Abdominal radiography showed dilated bowel loops and ultrasonogram showed worms in the small intestine and biliary tree...
January 1, 2018: Tropical Doctor
https://www.readbyqxmd.com/read/29624512/gastrointestinal-tract-vasculopathy-clinicopathology-and-description-of-a-possible-new-entity-with-protean-features
#7
Christine Y Louie, Michael A DiMaio, Gregory W Charville, Gerald J Berry, Teri A Longacre
Noninfectious gastrointestinal (GI) vasculopathic disorders are rare and are often overlooked in histopathologic examination or when forming differential diagnoses due to their rarity. However, involvement of the GI tract may lead to serious complications, including ischemia and perforation. Since awareness of the types of vasculopathy that may involve the GI tract is central to arriving at a correct diagnosis, we reviewed our institutional experience with GI tract vasculopathy in order to enhance diagnostic accuracy of these rare lesions...
April 5, 2018: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29620694/genetic-polymorphisms-associated-with-constipation-and-anticholinergic-symptoms-in-patients-receiving-clozapine
#8
Anssi Solismaa, Olli Kampman, Leo-Pekka Lyytikäinen, Niko Seppälä, Merja Viikki, Nina Mononen, Terho Lehtimäki, Esa Leinonen
BACKGROUND: Clozapine impairs gastrointestinal motility owing to its anticholinergic and antiserotonergic properties. This commonly leads to constipation and potentially to more severe complications such as bowel obstruction and ischemia. The aim of this study was to determine whether genetic variations in the genes encoding muscarinic and serotonergic receptors (CHRM2, CHRM3, HTR2, HTR3, HTR4, and HTR7) explain the variations in incidence of constipation and anticholinergic symptoms during clozapine treatment...
April 3, 2018: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29619340/takotsubo-cardiomyopathy-with-basal-hypertrophy-and-outflow-obstruction-in-a-patient-with-bowel-ischemia
#9
Ahmad Abuarqoub, Rana Garis, Hamid Shaaban, Ibrahim Khaddash, Fayez Shamoon
Basal septal hypertrophy is a rare and unique anatomical finding associated with hypertrophic cardiomyopathy (HCM). It is also described as a sigmoid hypertrophy and is linked with aging and chronic hypertension. Takotsubo cardiomyopathy is a transient cardiomyopathy that occurs during periods of high physical or emotional stress. Its occurrence with HCM is relatively common; however, this presentation occurs more often with the classic asymmetrical septal hypertrophy or the apical variant. This case demonstrates its coexistence with isolated sigmoid hypertrophy in an elderly, hypertensive female with severe ischemic bowel disease...
January 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29613861/trends-in-use-of-midodrine-in-the-icu-a-single-center-retrospective-case-series
#10
Mahrukh S Rizvi, Vrinda Trivedi, Faria Nasim, Erica Lin, Rahul Kashyap, Nicole Andrijasevic, Ognjen Gajic
OBJECTIVES: Midodrine is an oral alpha-agonist approved for orthostatic hypotension. The use of midodrine as a vasopressor sparing agent has steadily increased in the ICU despite limited evidence for its safety in that setting. We describe the trends in use and reported side effects and complications of midodrine in multidisciplinary ICUs of a tertiary care institution. DESIGN: Single-center retrospective case series. SETTING: Medical and surgical ICU patients from January 2011 to October 2016 at Mayo Clinic, Rochester...
March 31, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29602473/early-outcomes-with-a-single-sided-access-endovascular-stent
#11
Michael Hofmann, Felice Pecoraro, David Planer, Thomas Pfammatter, Gilbert Puippe, Dominique Bettex, Frank J Veith, Mario Lachat, Lyubov Chaykovska
OBJECTIVE: The objective of this study was to report the 1-year follow-up study results of the new Horizon stent graft (Endospan, Herzliya, Israel) from two different prospective consecutive trials. The Horizon abdominal aortic aneurysm stent graft system is a 14F profile system requiring only a single access site. It consists of three modules, introduced separately: base limb (iliac to iliac limb); distal aortic limb; and proximal aortic limb with a bare suprarenal crown and active fixation...
March 27, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29596283/pediatric-sigmoid-volvulus
#12
Bennett Lee, Andrea Wu
Sigmoid volvulus is an extremely rare cause of abdominal pain in children. More commonly seen in older adults, an SV occurs when a redundant loop of sigmoid wraps around its elongated, narrow mesentery causing obstruction and ischemia to the affected bowel segment. Children usually present with abdominal pain, nausea, and abdominal distension. Presentations may be acute or chronic with a history of episodic constipation or abdominal distension. The treatment plan includes an initial reduction of the volvulus via sigmoidoscopy with rectal biopsy to rule out Hirschsprung disease; however, operative management to remove the dilated sigmoid colon may be required in the setting of recurrence or confirmed Hirschsprung disease...
March 28, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29594895/clinical-implications-of-ct-findings-in-mesenteric-venous-thrombosis-at-admission
#13
S Salim, O Ekberg, J Elf, M Zarrouk, A Gottsäter, S Acosta
PURPOSE: The main aim of this study was to evaluate the association of computed tomography (CT) findings at admission and bowel resection rate in patients with mesenteric venous thrombosis (MVT). It was hypothesized that abnormal intestinal findings on CT were associated with a higher bowel resection rate. METHODS: Retrospective study of MVT patients treated between 2004 and 2017. CT images at admission and at follow-up were scrutinized according to a predefined protocol...
March 28, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29574759/humanizing-the-mouse-immune-system-to-study-splanchnic-organ-inflammation
#14
Brianyell McDaniel, Matthew B Grisham
It is well known that alterations in splanchnic organ perfusion and/or immune regulation may produce inflammatory tissue injury similar to that observed in several human disorders such as ischemia and reperfusion injury, food allergies, diabetes, inflammatory bowel disease and graft-versus-host disease. Mouse models have been tremendously important in defining the roles of the circulation, leukocyte trafficking, inflammatory mediator generation, immune regulation and the intestinal microbiota in the pathogenesis of acute and chronic inflammation...
March 24, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29571623/real-world-evidence-of-superiority-of-endovascular-repair-in-treating-ruptured-abdominal-aortic-aneurysm
#15
Akshay Kumar Gupta, Hanaa Dakour Aridi, Satinderjit Locham, Besma Nejim, Frank J Veith, Mahmoud B Malas
OBJECTIVE: The majority of previous studies, including randomized controlled trials, have failed to provide sufficient evidence of superiority of endovascular aneurysm repair (EVAR) over open aortic repair (OAR) of ruptured abdominal aortic aneurysm (rAAA) while comparing mortality and complications. This is in part due to small study size, patient selection bias, scarce adjustment for essential variables, single insurance type, or selection of only older patients. This study aimed to provide real-world, contemporary, comprehensive, and robust evidence on mortality of EVAR vs OAR of rAAA...
March 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29565259/role-of-platelet-rich-fibrin-on-intestinal-anastomosis-wound-healing-in-a-rat
#16
Necdet Özçay, Handan Özdemir, Hasan Besim
OBJECTIVES: The aim of the present study is to investigate the role of platelet rich fibrin(PRF) on the intestinal anastomotic wound healing in a mesenteric ischemia/reperfusion (I/R) rat model. METHODS: Forty male Sprague Dawley rats were allocated into four groups: Group I (n=10) Anastomosis to normal bowel; Group II (n=10) Anastomosis after I/R injury; Group III (n=10) Anastomosis and PRF; Group IV Anastomosis after I/R and PRF. Animals were followed up for 7 days, then sacrificed...
March 22, 2018: Biomedical Materials
https://www.readbyqxmd.com/read/29559756/acute-bowel-ischemia-associated-with-left-ventricular-thrombus-and-arteriovenous-extracorporeal-membrane-oxygenation
#17
Mary Huerter, Dean Govostis, Martin Ellenby, Eduardo Smith-Singares
Indications for extra corporeal membrane oxygenation (ECMO) have expanded in recent years, and it has become an invaluable tool in the care of adult patients in severe cardiogenic shock or respiratory failure. Understanding the physiologic effect of ECMO has also further developed, allowing for improvements in the management of the potential morbidities associated with this technology. Here, we present a case of acute bowel ischemia that developed while the patient was on central venoarterial ECMO.
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29549618/transcatheter-arterial-embolization-in-lower-gastrointestinal-bleeding-ischemia-remains-a-concern-even-with-a-superselective-approach
#18
Taina Nykänen, Erno Peltola, Leena Kylänpää, Marianne Udd
PURPOSE: To evaluate the safety, efficacy, and feasibility of transcatheter arterial embolization (TAE) in the treatment of lower gastrointestinal bleeding (LGIB). METHODS: Study group comprised all patients receiving angiography for LGIB in the Helsinki University Hospital during the period of 2004-2016. Hospital medical records provided the study data. Rebleeding, complication, and mortality rates (≤ 30 days) were the primary outcomes. Secondary outcomes included need for blood transfusions, durations of intensive care unit and hospital admissions, incidence of delayed rebleeding, and long-term complications, as well as overall survival...
March 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29548812/multicenter-study-of-retrograde-open-mesenteric-artery-stenting-through-laparotomy-for-treatment-of-acute-and-chronic-mesenteric-ischemia
#19
Gustavo S Oderich, Rodrigo Macedo, David H Stone, Edward Y Woo, Jean M Panneton, Timothy Resch, Nuno V Dias, Björn Sonesson, Marc L Schermerhorn, Jason T Lee, Manju Kalra, Randall R DeMartino, Giuliano de A Sandri, Emanuel J Ramos Tenorio
OBJECTIVE: Retrograde open mesenteric stenting (ROMS) through laparotomy was introduced as an alternative to surgical bypass in patients with acute mesenteric ischemia (AMI). The purpose of this study was to evaluate the indications and outcomes of ROMS for treatment of AMI and chronic mesenteric ischemia. METHODS: We reviewed the clinical data and outcomes of all consecutive patients treated by ROMS in seven academic centers from 2001 to 2013. ROMS was performed through laparotomy with retrograde access into the target mesenteric artery and stent placement using a retrograde or antegrade approach...
March 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29536746/the-preventive-effects-of-atorvastatin-and-n-acetyl-cysteine-in-experimentally-induced-ischemia-reperfusion-injury-in-rats
#20
M Yasar, I Erdi, B Kaya
AIM: We investigated the effects of atorvastatin and N-acetyl cysteine in decreasing ischemia-reperfusion damage after detorsion of a volvulus of the cecum and ascending colon. METHODS: Wistar albino rats (250-300 g) were divided into four groups. A cecal-ascending colon volvulus was created by the intestinal clockwise 720° rotation. At the end of one hour, the bowel was detorsioned. Group I (n = 7) was the sham (laparotomy) group, Group II (n = 7) the control (no treatment, volvulus or detorsion), Group III (n = 7) (N-acetyl cysteine administered ) , and Group IV (n = 7) (atorvastatin administered ) group...
2018: Bratislavské Lekárske Listy
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