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Bowel ischemia

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https://www.readbyqxmd.com/read/29458229/primary-closure-versus-bedside-silo-and-delayed-closure-for-gastroschisis-a-truncated-prospective-randomized-trial
#1
Ashwini S Poola, Pablo Aguayo, Jason D Fraser, Richard J Hendrickson, Katrina L Weaver, Katherine W Gonzalez, Shawn D St Peter
BACKGROUND: We report a prospective randomized trial comparing primary closure (PC) to bedside silo and delayed closure (DC) for babies with gastroschisis. METHODS: Patients were randomized to PC versus DC. We excluded those with atresia/necrosis, <34 weeks' gestation, or congenital anomalies. The primary outcome was length of stay (LOS). RESULTS: A total of 38 patients were included from August 2011 to August 2016; 18 patients underwent DC and 20 PC...
February 19, 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29455011/hybrid-retrograde-celiac-artery-stenting-for-acute-mesenteric-ischemia-after-gastric-surgery
#2
Duarte Rego, Paulo Almeida, Paulo Soares, Rui Almeida
INTRODUCTION: Celiac artery (CA) occlusions/stenosis are infrequently associated with liver ischemia due to its unique vascularization where portal vein provides about 75% of liver's perfusion. Collateral flow from gastroduodenal artery also provides, in most cases, enough blood supply to prevent ischemic hepatitis. In cases where these collateral pathways are compromised severe liver ischemia can occur. METHODS: We present a case of acute mesenteric ischemia following gastric surgery that was treated with a hybrid retrograde CA stenting...
February 15, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29453825/iatrogenic-hepatic-portal-venous-gas-following-balloon-endoscopy-in-a-patient-with-hepaticojejunostomy-stricture
#3
Hiroshi Kawakami, Tesshin Ban, Yoshimasa Kubota
Hepatic portal venous gas (HPVG) is caused by gastrointestinal (GI) mucosal damage alone or in combination with bowel distension, sepsis, and invasion by gas-producing bacteria. The most common cause is mesenteric ischemia associated with bowel necrosis. Iatrogenic HPVG is a rare condition that occurs following various endoscopic procedures 1 . Herein, we present an unusual case of HPVG following balloon endoscopy (BE). This article is protected by copyright. All rights reserved.
February 17, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29435987/the-phd1-oxygen-sensor-in-health-and-disease
#4
Kilian B Kennel, Julius Burmeister, Martin Schneider, Cormac T Taylor
The hypoxia-inducible factor (HIF) co-ordinates the adaptive transcriptional response to hypoxia in metazoan cells. The hypoxic sensitivity of HIF is conferred by a family of oxygen-sensing enzymes termed HIF hydroxylases. This family consists of three prolyl hydroxylases (PHD1-3) and a single asparagine hydroxylase termed factor inhibitor HIF (FIH). It has recently become clear that HIF hydroxylases are functionally non-redundant and have discreet but overlapping physiologic roles. Furthermore, altered abundance or activity of these enzymes is associated with a number of pathologies...
February 13, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29433829/acute-mesenteric-ischemia-a-critical-role-for-the-radiologist
#5
P Copin, M Zins, A Nuzzo, Y Purcell, S Beranger-Gibert, L Maggiori, O Corcos, V Vilgrain, M Ronot
Acute mesenteric ischemia is defined as an inadequate blood supply to the gastrointestinal tract resulting in ischemic and inflammatory injury that may progress to necrosis of the bowel wall. Prognosis is poor with a mortality rate greater than 95% without treatment, dropping to around 70% when surgical treatment is performed. Contrast-enhanced computed tomography (CT) has become the cornerstone of the diagnosis by showing features of vascular disorders (occlusion and/or insufficient blood supply) and features of intestinal ischemic injury...
February 9, 2018: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/29419563/a-nonsurgical-approach-to-mesenteric-vascular-disease
#6
Hossein Tabriziani, Armaghan Ahmad, Roberto Bergamaschi, William H Frishman
Mesenteric ischemia is a rare disorder, with considerably high morbidity and mortality rates. It can manifest in several ways, including acute mesenteric ischemia, chronic mesenteric ischemia, nonocclusive mesenteric ischemia, mesenteric venous thrombosis, and colonic ischemia. Of these, acute mesenteric ischemia is the most severe form of intestinal ischemia, with a high mortality rate. The mainstay of therapy for mesenteric ischemia is surgical exploration and resection of infarcted bowel; however, medical therapy can play an important adjunctive role...
March 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29413213/mesenteric-ischemia
#7
REVIEW
Robin M Lawson
Mesenteric ischemia is an uncommon disease most often seen in the elderly. This disease results from blood flow in the mesenteric circulation that inadequately meets metabolic needs of the visceral organs and, if untreated, eventually leads to necrosis of the bowel wall. Mesenteric ischemia is divided into 2 types: acute mesenteric ischemia (AMI) and chronic mesenteric ischemia (CMI). Delayed diagnosis of CMI can lead to AMI. AMI is associated with extremely high mortalities. Early diagnosis via computed tomography angiography and prompt revascularization via endovascular therapy are recommended for symptomatic patients who have not developed bowel ischemia and necrosis...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29395428/institutional-experience-with-the-zenith-fenestrated-aortic-stent-graft
#8
S Keisin Wang, Ashley R Gutwein, Alok K Gupta, Gary W Lemmon, Alan P Sawchuk, Raghu L Motaganahalli, Michael P Murphy, Andres Fajardo
OBJECTIVE: The Zenith Fenestrated (ZFEN; Cook Medical, Bloomington, Ind) aortic stent graft system was approved for commercial use by the Food and Drug Administration in April 2012. We report our single-center experience of 100 consecutive patients treated with the ZFEN platform from October 2012 to March 2017. METHODS: A retrospective review of our prospectively maintained fenestrated endovascular aneurysm repair (FEVAR) database at a tertiary care academic institution located in the Midwest United States was performed for descriptive analysis...
January 27, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29387956/predictive-factors-for-intestinal-transmural-necrosis-in-patients-with-acute-mesenteric-ischemia
#9
Sameh Hany Emile
BACKGROUND: Acute mesenteric ischemia (AMI) is a serious and potentially fatal condition. No definite parameter can predict transmural bowel necrosis in patients with AMI to justify early surgical intervention. The current study aimed to identify the clinical, laboratory, and radiologic parameters that can successfully predict the onset of intestinal transmural necrosis in patients with AMI. PATIENTS AND METHODS: Records of patients with AMI in the period of January 2013 to October 2017 were reviewed...
January 31, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29386309/increased-serum-lactate-in-peritoneal-dialysis-patients-presenting-with-intercurrent-illness
#10
Emilie Trinh, Joanne M Bargman, Nalinee Saiprasertkit
BACKGROUND: Lactate is the most commonly used buffer in peritoneal dialysis (PD) solutions. While previous studies have shown that serum lactate is normal in stable PD patients, the purpose of our study was to evaluate whether abnormal lactate values are more common in PD patients presenting to the emergency department (ED) and have the same significance as in the general population. METHODS: This observational cohort study assessed the prevalence of elevated serum lactate in PD patients presenting to the ED and evaluated clinical factors associated with an abnormal lactate value...
January 31, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29384923/emergency-transcatheter-arterial-embolization-for-massive-gastrointestinal-arterial-hemorrhage
#11
Zhong Xing Shi, Jing Yang, Hong Wei Liang, Zhen Hua Cai, Bin Bai
To evaluate the different arteriographic manifestations of acute arterial massive hemorrhage of the gastrointestinal (GI) tract and the efficacy of emergency transcatheter arterial embolization (ETAE).A total of 88 patients with acute massive GI bleeding who experienced failure of initial endoscopy and/or conservative treatment were referred to our interventional department for acute GI arteriography from January 2007 to June 2015. After locating the source of bleeding, appropriate embolic agents, such as spring coil, hydroxyl methyl acrylic acid gelatin microspheres, polyvinyl alcohol (PVA) particles, etc...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29383022/endoscopic-full-thickness-biopsy-a-novel-method-in-the-work-up-of-complicated-abdominal-symptoms
#12
Bodil Ohlsson, Rita Gustafsson, Fredrik Swahn, Ervin Toth, Béla Veress, Henrik Thorlacius
Gastrointestinal complaints without obvious organic causes confirmed by clinical laboratory analyses, endoscopy or radiology are often referred to functional entities. Irritable bowel syndrome (IBS) is the most common functional disorder in the gut. Careful examination of these patients may reveal other diagnoses of defined etiologies, e.g., enteric neuropathy, microscopic colitis, and primary Sjögre's syndrome. The present case describes a young patient with incapacitating gastrointestinal symptoms presumed to be IBS, who underwent endoscopic full-thickness biopsy in sigmoid colon...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29358892/emergent-single-balloon-enteroscopy-for-overt-bleeding-of-small-intestinal-vascular-malformation
#13
Chen-Shuan Chung, Kuan-Chih Chen, Yueh-Hung Chou, Kuo-Hsin Chen
A 28-year-old man presented with anemia symptoms and intermittent tarry stool passage for three days. No stigmata of hemorrhage were identified using esophagogastroduodenoscopy, ileocolonoscopy, and contrast-enhanced computed tomography. He then developed massive tarry stool passage with profound hypovolemic shock and hypoxic respiratory failure. Emergent angiography revealed active bleeder, probably from the jejunal branches of the superior mesenteric artery, but embolization was not performed due to possible subsequent extensive bowel ischemia...
January 7, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29358413/the-hypoxia-adenosine-link-during-intestinal-inflammation
#14
REVIEW
Jessica L Bowser, Luan H Phan, Holger K Eltzschig
Intestinal inflammation is a key element in inflammatory bowel disease and is related to a combination of factors, including genetics, mucosal barrier dysfunction, bacteria translocation, deleterious host-microbe interactions, and dysregulated immune responses. Over the past decade, it has been appreciated that these inflammatory lesions are associated with profound tissue hypoxia. Interestingly, an endogenous adaptive response under the control of hypoxia signaling is enhancement in adenosine signaling, which impacts these different endpoints, including promoting barrier function and encouraging anti-inflammatory activity...
February 1, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/29358066/portomesenteric-vein-thrombosis-in-sleeve-gastrectomy-a-10-year-review
#15
Stephanie Bee Ming Tan, Justin Greenslade, David Martin, Michael Talbot, Ken Loi, George Hopkins
BACKGROUND: Worldwide, the laparoscopic sleeve gastrectomy (LSG) is becoming the dominant bariatric procedure due to its reliable weight loss and low complication rate. Portomesenteric vein thrombosis (PVT) is an uncommon complication of LSG with an incidence of .3% to 1% and can lead to serious consequences, such as bowel ischemia and death. OBJECTIVES: This paper will present the presentation, risk factors, treatment, and long-term outcomes of patients who had PVT post-LSG...
December 15, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29354607/surgical-outcomes-and-risk-factors-in-patients-who-underwent-emergency-colorectal-surgery
#16
Dai Sik Jeong, Young Hun Kim, Kyung Jong Kim
Purpose: Emergency colorectal surgery has high rates of complications and mortality because of incomplete bowel preparation and bacterial contamination. The authors aimed to evaluate the surgical outcomes and the risk factors for the mortality and the complication rates of patients who underwent emergency surgery to treat colorectal diseases. Methods: This is a prospective study from January 2014 to April 2016, and the results are based on a retrospective analysis of the clinical results for patients who underwent emergency colorectal surgery at Chosun University Hospital...
December 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/29325325/-expression-of-microrna-155-in-inflammatory-bowel-disease-and-its-clinical-significance
#17
Y L Ye, Z Pang, W Gu, J J Zheng
Objective: To explore the expression of microRNA-155 in colonic mucosa and peripheral blood in patients with inflammatory bowel disease(IBD), and to examine the clinical value and significance of microRNA-155 in the diagnosis of IBD. Methods: Quatitative reverse-transcription PCR was performed to detect the expression of microRNA-155 in 20 patients with Crohn disease(CD), 21 patients with ulcerative colitis (UC), 18 patients with IBD type unclassified(IBDU), 25 healthy people(control group), 12 patients with infection colitis and 19 patients with ischemia colitis...
December 19, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29313164/treatment-of-nonocclusive-mesenteric-ischemia-with-type-b-aortic-dissection-using-intra-arterial-catheterization-after-trauma-surgery-case-report
#18
Sho Fujiwara, Yuki Sekine, Ryuichi Nishimura, Kazuya Tadasa, Shukichi Miyazaki
BACKGROUND: Nonocclusive mesenteric ischemia (NOMI) is a mesenteric arterial spasm and intestinal ischemia. This disease is a highly lethal disease because diagnosis and decision of appropriate treatments are often difficult. Operations cannot resolve the spasms and may worsen the situation. However, the safety and effectiveness of catheterization for NOMI with aortic dissection (AD) have not yet been elucidated. Here, we report a successful case of early diagnosis and treatment of NOMI with type B AD involving the superior mesenteric artery (SMA) using the intra-arterial infusion of a vasodilator via the SMA...
January 8, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29310345/inferior-mesenteric-arteriovenous-fistula-with-nonpulsatile-abdominal-mass-a-case-report-and-a-mini-review
#19
Ling Cheng, Ruifeng Zhao, Di Guo, Kailin Cai, Kaifang Zou, Jun Yang, Liangru Zhu
RATIONALE: Inferior mesenteric arteriovenous fistula (IMAVF) is a rare condition principally characterized by portal hypertension and ischemic bowel disease. Up to now, only 30 cases have been reported. Presented here is an IMAVF patient with nonpulsatile abdominal mass as the main manifestation. PATIENT CONCERNS: A 62-year-old Chinese male who complained of abdominal discomfort for a month was admitted to our hospital. Physical examination revealed a hard and hardly mobile mass...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29288316/risk-factors-for-mortality-and-morbidity-in-elderly-patients-presenting-with-digestive-surgical-emergencies
#20
Hassen Hentati, Chady Salloum, Philippe Caillet, Eylon Lahat, Mara Disabato, Eric Levesque, Philippe Compagnon, Chetana Lim, Daniel Azoulay
BACKGROUND: Emergency digestive surgery is being increasingly performed in elderly patients. The aim of the present study was to identify the predictors of mortality and morbidity following emergency digestive surgery in patients aged 80 years and older. METHODS: A single-center retrospective review was performed of consecutive patients aged ≥65 years operated for a digestive surgical emergency between January 2011 and December 2013. Two groups were compared: group A (aged 65-79 years) and group B (aged ≥80 years)...
December 30, 2017: World Journal of Surgery
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