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Bowel ischemia

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https://www.readbyqxmd.com/read/27921277/surgery-for-acute-exacerbation-of-chronic-mesenteric-ischemia-a-case-report
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/27824535/update-on-the-management-of-intestinal-failure
#9
REVIEW
Shishira Bharadwaj, Parul Tandon, John M Rivas, Anne Furman, Lisa Moccia, Ashley Ratliff, Abdullah Shatnawei, Ezra Steiger, Donald F Kirby
Intestinal failure is a serious complication of conditions such as inflammatory bowel disease, mesenteric ischemia, and radiation enteritis--and of extensive bowel resection performed because of these diseases. Imbalances of fluids and electrolytes and poor nutritional status manifest as chronic diarrhea or increased ostomy output. Prompt referral to a center specializing in intestinal rehabilitation is key to achieving nutritional homeostasis and, in some cases, can help the patient return to oral food intake...
November 2016: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/27819873/hydrophilic-polymer-associated-ischemic-enterocolitis
#10
Jesus A Chavez, Wei Chen, Wendy L Frankel, Christina A Arnold
Hydrophilic polymer coating of medical devices serves to lubricate the device and prevent device-related complications. The coating can be mechanically disrupted and result in downstream injury via presumed thromboembolism. This process has been reported in the brain, heart, lung, and skin, and has been replicated through animal studies and in vitro histologic processing of the polymer coating. We report the first description of hydrophilic polymer-associated ischemic enterocolitis in a series of 7 specimens (small bowel=2, colon=4, aortic thrombus=1) from 3 patients...
November 4, 2016: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/27792472/management-of-peritonitis-after-minimally-invasive-colorectal-surgery-can-we-stick-to-laparoscopy
#11
Alessandra Marano, Maria Carmela Giuffrida, Giorgio Giraudo, Luca Pellegrino, Felice Borghi
BACKGROUND: Although laparoscopy is becoming the standard of care for the treatment of colorectal disease, its application in case of postoperative peritonitis is still not widespread. The objective of this article is to evaluate the role of laparoscopy in the management of postoperative peritonitis after elective minimally invasive colorectal resection for malignant and benign diseases. MATERIALS AND METHODS: Between April 2010 and May 2016, 536 patients received primary minimally invasive colorectal surgery at our Department...
October 28, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27785322/common-inflammatory-disorders-and-neoplasia-of-the-ileal-pouch-a-review-of-histopathology
#12
REVIEW
David Hernandez Gonzalo, Amy L Collinsworth, Xiuli Liu
Ileal pouch-anal anastomosis (IPAA) is the standard restorative procedure after proctocolectomy in patients with ulcerative colitis (UC) who require colectomy. The ileal pouch is susceptible to a variety of insults including mechanical injury, ischemia, fecal stasis, and infectious agents. In addition, the development of recurrent and idiopathic inflammatory bowel disease and neoplasia may occur in the ileal pouch. Although clinical, endoscopic, and radiographic examination can diagnose many ileal pouch diseases, histologic examination plays an essential role in diagnosis and management, particularly in cases with antibiotic refractory chronic pouchitis and pouch neoplasia...
June 2016: Gastroenterology Research
https://www.readbyqxmd.com/read/27779991/predictors-of-ischemic-bowel-in-patients-with-small-bowel-obstruction
#13
Michael P O'Leary, Angela L Neville, Jessica A Keeley, Dennis Y Kim, Christian de Virgilio, David S Plurad
Preoperative diagnosis of ischemic bowel in patients with small bowel obstruction (SBO) is a clinical challenge. The aim of this study was to identify preoperative variables associated with ischemic bowel found at operative exploration. We performed a 5-year retrospective review of patients admitted to a university affiliated, county funded hospital who underwent exploratory laparoscopy or laparotomy for SBO. Patients were excluded if they had a known preoperative malignancy or hernia on physical examination...
October 2016: American Surgeon
https://www.readbyqxmd.com/read/27777711/cocaine-use-and-splenic-rupture-a-rare-yet-serious-association
#14
Nishrutha Karthik, Karthik Gnanapandithan
Cocaine abuse is frequent in patients visiting the emergency department. The knowledge of the cardiovascular complications of cocaine is excellent among physicians. However the awareness regarding its abdominal complications, the most important of which include gastroduodenal perforation, bowel ischemia and splenic rupture is less adequate. We report a 58-year-old with cocaine use who presents with upper abdominal pain and a rapidly worsening clinical status. He was found to have atraumatic splenic rupture causing a hemoperitoneum that was managed by intervention radiology guided splenic artery embolization...
August 8, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27771521/clinical-value-of-the-neutrophil-lymphocyte-ratio-in-diagnosing-adult-strangulated-inguinal-hernia
#15
Huanhao Zhou, Xiaojiao Ruan, Xia Shao, Xiaming Huang, Guan Fang, Xiaofeng Zheng
BACKGROUND: Diagnosis of incarcerated inguinal hernia (IIH) is not difficult, but currently, there are no diagnostic criteria that can be used to differentiate it from strangulated inguinal hernia (SIH). This research aimed to evaluate the clinical value of the neutrophil/lymphocyte ratio (NLR) in diagnosing SIH. METHODS: We retrospectively analyzed 263 patients with IIH who had undergone emergency operation. The patients were divided into two groups according to IIH severity: group A, patients with pure IIH validated during operation as having no bowel ischemia; group B, patients with SIH validated during operation as having obvious bowel ischemia, including bowel necrosis...
October 19, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27765954/both-the-anti-and-pro-apoptotic-functions-of-villin-regulate-cell-turnover-and-intestinal-homeostasis
#16
Yaohong Wang, Sudeep P George, Swati Roy, Eric Pham, Amin Esmaeilniakooshkghazi, Seema Khurana
In the small intestine, epithelial cells are derived from stem cells in the crypts, migrate up the villus as they differentiate and are ultimately shed from the villus tips. This process of proliferation and shedding is tightly regulated to maintain the intestinal architecture and tissue homeostasis. Apoptosis regulates both the number of stem cells in the crypts as well as the sloughing of cells from the villus tips. Previously, we have shown that villin, an epithelial cell-specific actin-binding protein functions as an anti-apoptotic protein in the gastrointestinal epithelium...
October 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27759602/abdominal-multidetector-computed-tomography-for-suspected-small-bowel-obstruction-multireader-study-comparing-radiologist-performance-for-predicting-surgical-outcomes
#17
Andrew Scrima, Meghan G Lubner, Scott King, Gregory Kennedy, Perry J Pickhardt
OBJECTIVE: To compare performance of junior (JR)/senior (SR) abdominal radiologists using multidetector computed tomography (MDCT) to predict surgical intervention, bowel resection, and presence of bowel ischemia in patients with suspected small-bowel obstruction (SBO). METHODS: Retrospective, institutional review board-approved, Health Insurance Portability and Accountability Act-compliant, blinded, independent review of MDCT studies for suspected SBO in 179 adults (mean age, 55...
October 18, 2016: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/27742898/initial-experience-with-covered-endovascular-reconstruction-of-the-aortic-bifurcation-in-conjunction-with-chimney-grafts
#18
Martijn L Dijkstra, Peter C J M Goverde, Andrew Holden, Clark J Zeebregts, Michel M P J Reijnen
PURPOSE: To show feasibility of the covered endovascular repair of the aortic bifurcation (CERAB) technique in conjunction with chimney grafts in aortic side branches for complex aortoiliac occlusive disease. METHODS: Two European centers and one facility located in New Zealand participated in a retrospective observational study that enrolled 14 consecutive patients (mean age 61.2±8.9 years; 11 men) treated with CERAB in conjunction with chimney graft(s) between December 2012 and May 2015...
October 14, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27742300/n-acetylcysteine-use-in-hepatic-ischemia-reperfusion-in-rats-minimizing-bowel-injury
#19
S H Lauz Medeiros, A de Oliveira Menezes, L Zogbi, E Frasson de Souza Montero
BACKGROUND: The ischemia/reperfusion (I/R) phenomenon can cause the dysfunction of some transplanted organs and other distant organs. Liver surgery success, including transplantations, may depend on the adverse effects of intestinal mucosa injury arising from temporary porta triad occlusion. The study objective was to examine I/R liver effects on the small intestine in rats after N-acetylcysteine (NAC) treatment. METHODS: Twenty-four male Wistar rats were randomly divided into 2 groups...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27721091/small-bowel-volvulus-due-to-torsion-of-pedunculated-uterine-leiomyoma-ct-findings
#20
Nicola Guglielmo, Brice Malgras, Vinciane Place, Youcef Guerrache, Karine Pautrat, Marc Pocard, Philippe Soyer
Torsion of a uterine leiomyoma is a rare complication that can be life threatening because of ischemia or necrosis. This condition may also lead to gastrointestinal complications such as obstruction or, more rarely, small bowel volvulus. Its diagnosis is difficult and can be facilitated with the use of computed tomography or magnetic resonance imaging. Treatment is based on emergency surgical resection of the twisted uterine leiomyoma and detorsion of the small bowel volvulus.
September 28, 2016: Clinical Imaging
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