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Small bowl ischemia

H Listle, C Gutt
The diagnosis ileus is one of the most common indications for an emergency laparotomy. In 70% of the cases, the small intestine is affected, and in 30% it is the colorectum. While stuck hernias are a major cause in developing countries, the most common causes in western countries are postoperative adhesions that lead to an acute bowl obstruction. The timeframe for treatment of a complete mechanical obstruction is short as acute ischemia can lead to necrosis with bowl perforation within 6 h. The perioperative lethality for an emergency laparotomy due to an ileus ranges from 5-15%...
July 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
R A M Camprodon, M J Bowles, A G Pockley, J de Oca
INTRODUCTION: Minimizing the inflammatory events that follow intestinal transplantation may influence immediate graft function and improve outcome. Ischemic preconditioning (IPc) has been shown to ameliorate early inflammatory responses, and it may also attenuate the potentially damaging inflammation after intestinal transplantation. Herein, we examine the influence of intestinal IPc on inflammatory indices (tissue expression of ICAM-1, CD11a, and CD44 and serum levels of the soluble ICAM-1, sICAM-1) after heterotopic intestinal transplantation...
July 2014: Transplantation Proceedings
Markus Wallwiener, Christian W Wallwiener, Roger Molinas, Taufiek K Rajab, Sara Y Brucker, Bernhard Kraemer, Andreas D Hartkopf
PURPOSE: Intraabdominal adhesions represent a major cause of postoperative morbidity potentially causing pain, small bowl obstruction and infertility. The process of adhesion formation might be regarded as an ischemic disease. Under hypoxic conditions, metabolic enzymes are regulated via hypoxic responsive elements by the hypoxia-inducible factor 1 (HIF-1). We therefore investigated the gene expression of HIF-1 and two pivotal metabolic genes, pyruvate-dehydrogenaseβ (PDHb) and succinate-dehydrogenase-complex-subunit-A (SDHa) in a validated ischemia model of adhesion formation...
September 2012: Archives of Gynecology and Obstetrics
Andrea N Sarap, Michael D Sarap, Jennifer Childers
Early recognition and appropriate treatment of bowel ischemia is imperative to reduce morbidity and mortality in any situation, including in conjunction with enteral tube feeding. GI intolerance can manifest as increased nasogastric tube output, unexplained abdominal pain/distension, and pneumatosis intestinalis in critically ill patients who are on tube feedings and may be experiencing periods of splanchnic hypotension. Recommendations are to immediately cease tube feedings when these signs and symptoms are recognized, and total parenteral nutrition should be considered...
November 2010: JAAPA: Official Journal of the American Academy of Physician Assistants
Yu-Hui Chiu, Ming-Kun Huang, Chorng-Kuang How, Teh-Fu Hsu, Jen-Dar Chen, Chii-Hwa Chern, David Hung-Tsang Yen, Chun-I Huang
OBJECTIVES: The aims of this study were to assess the diagnostic value of D-dimer in patients with suspected acute mesenteric ischemia (AMI) and to evaluate the correlation between D-dimer levels and the severity of bowel necrosis. METHODS: A prospective, noninterventional study of 67 patients with clinical suspicion of AMI was performed. Measurement of D-dimer levels was performed using a latex turbidimetric method. RESULTS: Acute mesenteric ischemia was diagnosed in 23 patients (34...
October 2009: American Journal of Emergency Medicine
Jessica M Leers, Carlo Vivaldi, Hartmut Schäfer, Marc Bludau, Jan Brabender, Georg Lurje, Till Herbold, Arnulf H Hölscher, Ralf Metzger
BACKGROUND: Leaks of the esophagus are associated with a high mortality rate and need to be treated as soon as possible. Therapeutic options are surgical repair or resection or conservative management with cessation of oral intake and antibiotic therapy. We evaluated an alternative approach that uses self-expandable metallic stents (SEMS). METHODS: Between 2002 and 2007, 31 consecutive patients with iatrogenic esophageal perforation (n = 9), intrathoracic anastomotic leak after esophagectomy (n = 16), spontaneous tumor perforation (n = 5), and esophageal ischemia (n = 1) were treated at our institution...
October 2009: Surgical Endoscopy
Takanori Omae, Maki Goto, Masahiro Shimomura, Satohiro Masuda, Kimitaka Ito, Masahiro Okuda, Ken-ichi Inui
Ischemia-reperfusion injury is an unavoidable problem for organ transplantation including small bowel transplantation, and causes a large intra-individual variation of tacrolimus (FK506) pharmacokinetics. Little information is available about the regulation of the intestinal P-glycoprotein expression during tissue regeneration. In the present study, we have examined the molecular and functional variations of ileum P-glycoprotein using rats after ischemia-reperfusion treatment. Morphological study revealed a rapid regeneration of the intestinal wall during 24 h after reperfusion...
February 15, 2005: Biochemical Pharmacology
A H Cheung, K Y Wang, G C Jiranek, S Odegaard, M B Kimmey, F E Silverstein
The authors have previously demonstrated the ability of an 8.5-MHz linear array to detect moderate or severe intestinal ischemia in a porcine model. This study compares the ability of the 8.5-MHz linear array with a prototype miniature 20-MHz ultrasound (US) imaging probe in detecting small bowel ischemia. Five piglets were studied in which vascular clamps were applied to isolated jejunal pedicles, then released sequentially at hourly intervals to induce ischemia from 0 to 6 hours. After 24 hours of reperfusion, the tissue was removed and examined with both the 8...
March 1992: Investigative Radiology
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