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https://www.readbyqxmd.com/read/28425094/fatal-acute-hemorrhagic-bowel-infarction-caused-by-mesenteric-venous-thrombosis
#1
Supawon Srettabunjong
Acute mesenteric venous thrombosis (MVT) is a rare, but life-threatening medical phenomenon. MVT is normally characterized by insidious onset, with nonspecific signs and symptoms. A high index of clinical suspicion is required for diagnosis, and emergency surgery is necessary to optimize the chances of patient survival, especially in the people aged more than 70 years. Surprisingly, based on my review of the literature, no fatal acute MVT case has been reported in the forensic literature. All reported such cases have been documented in medical literature, and most of them have been associated with underlying risk factors for venous thrombosis, such as hypercoagulable state, certain cancers, and stasis of the blood flow...
April 20, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28420518/acute-small-bowel-obstruction-caused-by-barbed-suture-on-the-second-day-after-laparoscopic-hysterosacropexy-a-case-report-and-literature-review
#2
Hsuan Chen, Mun-Kun Hong, Dah-Ching Ding
OBJECTIVE: To report a case of small bowel obstruction caused by barbed suture applied in hysterosacropexy, and possible solutions. CASE REPORT: A 57-year-old woman underwent laparoscopic hysterosacropexy for a Stage 2 uterine prolapse, presenting with acute abdominal pain and a bowel obstruction syndrome 2 days following the surgery. Conservative treatment was given, but the symptoms did not improve and gradually became worse. Diagnostic laparoscopy was performed on the 7(th) day after the hysterosacropexy, and the volvulus was found...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28399982/value-of-multi-detector-ct-in-detection-of-isolated-spontaneous-superior-mesenteric-artery-dissection
#3
Li Tao, Zhao Shaohong, Li Jinfeng, Huang Zili, Luo Chuncai, Yang Li
Objective To investigate the role of multi-detector computed tomography (CT) in the diagnosis and classification of isolated spontaneous superior mesenteric artery dissection (ISSMAD). Methods From July 2012 to December 2016, 30 consecutive patients with ISSMAD underwent CT scan at least two times. We retrospectively summarized the clinical characteristics and CT findings of them. The stenosis ratio of true lumen was compared between the patients without bowel ischemia and ones with bowel ischemia. Results There were 5 cases of type I ISSMAD, 14 cases of type 2, 1 case of type 3, 7 cases of type 4 and 3 cases of type V...
April 10, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28395785/acute-mesenteric-ischemia-part-ii-vascular-and-endovascular-surgical-approaches
#4
REVIEW
Jussi M Kärkkäinen, Stefan Acosta
The modern treatment of acute mesenteric ischemia (AMI) requires seamless collaboration of gastrointestinal surgeons, vascular surgeons, and interventional radiologists. The treatment strategy is straightforward aiming at rapid restoration of blood flow to the intestine. Bowel resection is performed on demand. The first thing to consider is the patient's clinical condition at presentation, whether there are signs of peritonitis or not, and whether the patient is hemodynamically stable or not. Second, there are four etiologies of AMI that need to be distinguished as they differ in treatment: superior mesenteric artery embolism, mesenteric arterial occlusive disease, mesenteric venous thrombosis, and non-occlusive mesenteric ischemia...
February 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28392914/the-use-of-super-selective-mesenteric-embolisation-as-a-first-line-management-of-acute-lower-gastrointestinal-bleeding
#5
Bryan Soh, Steven Chan
INTRODUCTION: In this study, we aim to assess the efficacy and safety of digital subtraction angiography (DSA) and super-selective mesenteric artery embolisation in managing lower gastrointestinal bleeding (LGIB) at a multi-centre health service in Melbourne (Australia). METHOD: A retrospective case series of patients with LGIB treated with superselective embolisation in our area health service. Patients with confirmed active LGIB, on either radionuclide scintigraphy (RS) or contrast-enhanced multi-detector CT angiography (CE-MDCT), were referred for DSA, and subsequently endovascular intervention...
May 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28385380/outcomes-of-bedside-sutureless-umbilical-closure-without-endotracheal-intubation-for-gastroschisis-repair-in-surgical-infants
#6
Gillian E Pet, Rebecca A Stark, John J Meehan, Patrick J Javid
INTRODUCTION: Newborns with gastroschisis have historically undergone surgical repair under general anesthesia. Our institution recently transitioned to the sutureless umbilical closure for gastroschisis. We sought to evaluate the feasibility of bedside gastroschisis repair without endotracheal intubation. METHODS: A retrospective review was performed of neonates with gastroschisis who underwent sutureless umbilical closure from 2011 to 2015. Clinical characteristics and outcomes between groups were compared...
March 24, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28385296/17%C3%AE-estradiol-prevents-mesenteric-injury-induced-by-occlusion-of-the-proximal-descending-aorta-in-male-rats
#7
Paulo Thales Rocha de Sousa, Ana Cristina Breithaupt-Faloppa, Cristiano de Jesus Correia, Raif Restivo Simão, Sueli Gomes Ferreira, Alfredo Inácio Fiorelli, Luiz Felipe Pinho Moreira, Paulina Sannomiya
OBJECTIVE: In surgical aortic repair or cardiac surgery with aorta occlusion, the occurrence of mesenteric ischemia and bowel injury has been associated with higher short-term mortality. The vascular protection of estrogens has been investigated and is mainly mediated by increasing the availability of nitric oxide (NO). Therefore, this study investigated the role of 17β-estradiol on visceral ischemia-reperfusion (I/R) injury after descending aorta occlusion in male rats. METHODS: Mesenteric ischemia was induced in male Wistar rats by placing a 2F Fogarty arterial embolectomy catheter (Edwards Lifesciences, Irvine, Calif) in the descending aorta, which remained occluded for 15 minutes, followed by reperfusion for up to 2 hours...
April 3, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28356517/protectin-d1n-3-dpa-and-resolvin-d5n-3-dpa-are-effectors-of-intestinal-protection
#8
Thomas Gobbetti, Jesmond Dalli, Romain A Colas, Donata Federici Canova, Marius Aursnes, Delphine Bonnet, Laurent Alric, Nathalie Vergnolle, Celine Deraison, Trond V Hansen, Charles N Serhan, Mauro Perretti
The resolution of inflammation is an active process orchestrated by specialized proresolving lipid mediators (SPM) that limit the host response within the affected tissue; failure of effective resolution may lead to tissue injury. Because persistence of inflammatory signals is a main feature of chronic inflammatory conditions, including inflammatory bowel diseases (IBDs), herein we investigate expression and functions of SPM in intestinal inflammation. Targeted liquid chromatography-tandem mass spectrometry-based metabololipidomics was used to identify SPMs from n-3 polyunsaturated fatty acids in human IBD colon biopsies, quantifying a significant up-regulation of the resolvin and protectin pathway compared with normal gut tissue...
March 29, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28348948/microscopic-polyangiitis-atypical-presentation-with-extensive-small-bowel-necrosis-diffuse-alveolar-hemorrhage-and-renal-failure
#9
Justin M Segraves, Vivek N Iyer
Microscopic polyangiitis is an uncommon systemic vasculitis of varying severity that is associated with myeloperoxidase (MPO) and perinuclear antineutrophil cytoplasmic (p-ANCA) antibodies. The most commonly affected organs are the lungs and kidneys. We report on a very unusual case of microscopic polyangiitis presenting with severe mesenteric ischemia in addition to diffuse alveolar hemorrhage and acute renal failure. The patient was initially diagnosed with acute pancreatitis at an outside facility given his severe abdominal pain and elevated pancreatic enzymes...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28341511/open-and-endovascular-abdominal-aortic-injury-repair-outcomes-in-polytrauma-patients
#10
Anand Dayama, Aksim Rivera, Odunayo Olorunfemi, Ahmed Mahmoud, Catherine A Fontecha, John McNelis
INTRODUCTION: The management of patients with abdominal aortic injury (AAI) remains challenging. Open repair of AAI is still the standard of care, however, open repair is associated with high mortality. In past few years endovascular surgery has evolved as a less invasive alternative to open surgery in emergency settings. The objective of this study was to compare outcomes after open repair vs. endovascular repair of AAI in poly-trauma patients. METHODS: The National Trauma Data Bank, from 2008-2012, was queried to identify trauma patients undergoing open and endovascular repair of AAI using ICD-9 codes...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28341118/efficacy-of-emergency-transarterial-embolization-in-acute-lower-gastrointestinal-bleeding-a-single-center-experience
#11
C Bua-Ngam, J Norasetsingh, T Treesit, B Wedsart, O Chansanti, J Tapaneeyakorn, T Panpikoon, S A-O Vallibhakara
PURPOSE: The purpose of this study was to assess the safety and efficacy of transcatheter arterial embolization (TAE) in the treatment of acute lower gastrointestinal bleeding (LGIB) and to determine the potential factors that influence treatment outcome. MATERIAL AND METHODS: A total of 38 patients with acute LGIB who were treated by TAE were retrospectively included. There were 24 men and 14 women, with a mean age of 61 years (range: 9-84 years). Patient characteristics, laboratory findings, treatments, causes of bleeding, angiographic findings, and outcomes were reviewed...
March 21, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28331640/a-case-of-hepatic-portal-venous-gas-hypothesis-of-a-transient-direct-communication-between-a-penetrating-antral-gastric-ulcer-and-mesenteric-varices
#12
Hassan M Ghoz, Shamlan M Sheikh, Kanika Khandelwal, Joseph Fiore, Nicholas James, Joel Weinstock
Hepatic portal venous gas (HPVG) is a rare radiological sign that usually signifies an acute intra-abdominal process, most commonly bowel ischemia and sepsis. Few reports described an association with underlying gastric pathologies. We report a 60-year-old patient who presented with melena and chills and was discovered to have a gastric ulcer that appeared to have penetrated into a mesenteric varix. This, in turn, likely caused development of HPVG associated with fungemia. Treatment with a proton pump inhibitor and bowel rest was sufficient to resolve symptoms and the HPVG...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28328258/value-of-mdct-and-clinical-and-laboratory-data-for-predicting-the-need-for-surgical-intervention-in-suspected-small-bowel-obstruction
#13
Andrew Scrima, Meghan G Lubner, Scott King, Joshua Pankratz, Gregory Kennedy, Perry J Pickhardt
OBJECTIVE: The purpose of this article is to assess the value of a large panel of clinical and MDCT variables in patients with suspected small-bowel obstruction (SBO) for predicting urgent surgical intervention (< 72 hours), bowel ischemia, and bowel resection. MATERIALS AND METHODS: MDCT studies performed at admission for 179 nonconsecutive adults (mean age, 55.8 years; 86 men and 93 women) with suspected SBO were retrospectively reviewed by three board-certified radiologists...
April 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28316934/neobladder-obstruction-a-non-ischemic-cause-for-hepatic-portal-venous-gas-case-report
#14
Haider K Bangash, Steve P McCombie, Omar K Bangash, Dickon Hayne
Hepatic portal venous gas (HPVG) is a rare ominous radiological sign usually indicative of mesenteric ischemia. Increased detection of HPVG has been associated with a growing number of non-ischemic causes. A 64-year-old gentleman following radical cystectomy and neobladder formation developed clinical signs suggestive of bowel obstruction. HPVG was demonstrated on abdominal imaging. Urgent laparotomy revealed no evidence of ischemia. We hypothesize an obstructed neobladder permitted gas to enter the mesenteric circulation...
May 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28314199/unusual-ultrasound-appearance-of-small-bowel-intussusception-and-secondary-bowel-obstruction-in-a-child-with-peutz-jeghers-syndrome
#15
Lei Wu, Ramesh S Iyer, George T Drugas, A Luana Stanescu
Small bowel intussusception (SBI) in pediatric patients resolves spontaneously in the majority of cases. Pathologic small bowel intussusception with a lead point is rare in children. Ultrasound (US) is the preferred initial imaging study for the diagnosis of intussusception. We report a case of long-segment SBI and secondary bowel obstruction caused by a large hamartomatous polyp. This case emphasizes unique, atypical ultrasound findings that may be encountered in small bowel intussusception, with correlative radiographic, CT (computed tomography) and intra-operative findings...
March 9, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28273609/a-rare-case-of-a-strangulated-littre-s-hernia-with-meckel-s-diverticulum-duplication-case-report-and-literature-review
#16
C R López-Lizárraga, M P Sánchez-Muñoz, G E Juárez-López, L Pelayo-Orozco, L F De la Cerda-Trujillo, C F Ploneda-Valencia
INTRODUCTION: The Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract present in approximately 1-4% of the population; the MD duplication is exceedingly rare with only a few reports of it. Here we present the firs case of a strangulated Littre's hernia with MD duplication. PRESENTATION OF CASE: A 30-year-old male presented to the emergency room with clinical signs of small bowel obstruction, at physical examination, a right incarcerated inguinal hernia with erythema was found...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28266590/predictive-factors-of-intestinal-necrosis-in-acute-mesenteric-ischemia-prospective-study-from-an-intestinal-stroke-center
#17
Alexandre Nuzzo, Leon Maggiori, Maxime Ronot, Aymeric Becq, Aurelie Plessier, Nathalie Gault, Francisca Joly, Yves Castier, Valerie Vilgrain, Catherine Paugam, Yves Panis, Yoram Bouhnik, Dominique Cazals-Hatem, Olivier Corcos
OBJECTIVES: To identify predictive factors for irreversible transmural intestinal necrosis (ITIN) in acute mesenteric ischemia (AMI) and establish a risk score for ITIN. METHODS: This single-center prospective cohort study was performed between 2009 and 2015 in patients with AMI. The primary outcome was the occurrence of ITIN, confirmed by specimen analysis in patients who underwent surgery. Patients who recovered from AMI with no need for intestinal resection were considered not to have ITIN...
April 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28261615/can-the-preoperative-serum-lactate-level-predict-the-extent-of-bowel-ischemia-in-patients-presenting-to-the-emergency-department-with-acute-mesenteric-ischemia
#18
Peter C Ambe, Kai Kang, Marios Papadakis, Hubert Zirngibl
Purpose. Early recognition of acute mesenteric ischemia (AMI) can be challenging. Extensive bowel necrosis secondary to AMI is associated with high rates of mortality. The aim of this study was to investigate the association between preoperative serum lactate level and the extent of bowel ischemia in patients with AMI. Methods. Data of patients with abdominal pain and elevated serum lactate undergoing emergency laparotomy for suspected AMI within 24 hours of presentation was retrospectively abstracted. The length of the ischemic bowel segment was compared with the preoperative serum lactate level...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28259577/outcomes-of-fenestrated-and-branched-endovascular-repair-of-complex-abdominal-and-thoracoabdominal-aortic-aneurysms
#19
Andres Schanzer, Jessica P Simons, Julie Flahive, Jonathan Durgin, Francesco A Aiello, Danielle Doucet, Robert Steppacher, Louis M Messina
BACKGROUND: More than 80% of infrarenal aortic aneurysms are treated by endovascular repair. However, adoption of fenestrated and branched endovascular repair for complex aortic aneurysms has been limited, despite high morbidity and mortality associated with open repair. There are few published reports of consecutive outcomes, inclusive of all fenestrated and branched endovascular repairs, starting from the inception of a complex aortic aneurysm program. Therefore, we examined a single center's consecutive experience of fenestrated and branched endovascular repair of complex aortic aneurysms...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28259479/-management-of-mesenteric-ischemia-in-the-era-of-intestinal-stroke-centers-the-gut-and-lifesaving-strategy
#20
A Nuzzo, O Corcos
Mesenteric ischemia is a gut and life-threatening, medical and surgical, digestive and vascular emergency. Mesenteric ischemia is the result of an arterial or venous occlusion, a vasospasm secondary to low-flow states in intensive care patients, aortic clamping during vascular surgery or intestinal transplantation. Progression towards mesenteric infarction and its complications is unpredictable and correlates with high rates of mortality or a high risk of short bowel syndrome in case of survival. Thus, mesenteric ischemia should be diagnosed and treated at an early stage, when gut injury is still reversible...
March 1, 2017: La Revue de Médecine Interne
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