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Acute mesenteric ischemia

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https://www.readbyqxmd.com/read/28323233/iloprost-use-in-patients-with-persistent-intestinal-ischemia-unsuitable-for-revascularization
#1
Alexandre Nuzzo, Damien Soudan, Lore Billiauws, Julie Bataille, Léon Maggiori, Maxime Ronot, Jeanick Stocco, Yoram Bouhnik, Yves Castier, Olivier Corcos
INTRODUCTION: Persistent or chronic intestinal ischemic injury (i3) can lead to severe malnutrition and acute mesenteric ischemia. Although recommended, revascularization of splanchnic arteries is sometimes unrealizable. MATERIAL AND METHODS: We report a case series of iloprost use in consecutive stable patients with persistent i3 unsuitable for revascularization followed in a tertiary care center. The feasibility of revascularization was discussed and ruled out by a multidisciplinary team, and informed consent was obtained prior to consideration of a vasoactive therapy...
March 16, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28321558/a-novel-scoring-system-for-diagnosing-acute-mesenteric-ischemia-in-the-emergency-ward
#2
Zhen Wang, Jun-Qiang Chen, Jin-Lu Liu, Lei Tian
BACKGROUND: Early diagnosis of acute mesenteric ischemia (AMI) based on clinical judgment has been proved to be too difficult. Therefore, it is important for identifying clinical parameters that can differentiate AMI from other acute abdomen upon presentation. METHODS: We analyzed a database of 106 consecutive patients admitted to the emergency ward for suspected AMI in whom diagnosis of AMI was confirmed by laparotomy, CT angiography or mesenteric angiography. The patients' demographics, previous history, clinical signs, results of laboratory investigations and ultrasonography were collected...
March 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28271679/the-diagnostic-value-of-scube1-in-acute-appendicitis
#3
E Sonmez, A Dursun, B Gulen, H Metin, O F Ozer
BACKGROUND: SCUBE1 has recently been studied as a diagnostic biomarker for acute coronary syndrome, ischemic stroke, and acute mesenteric ischemia. The aim of this study is to evaluate the value of SCUBE1 and routine parameters used in patients diagnosed with acute appendicitis. METHODS: Of the 150 patients admitted to the emergency department whose initial diagnosis were acute appendicitis (AA), 103 patients were excluded from the study for various reasons. Forty-seven patients with a definitive diagnose of AA and 43 volunteers were enrolled in the study...
March 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28266590/predictive-factors-of-intestinal-necrosis-in-acute-mesenteric-ischemia-prospective-study-from-an-intestinal-stroke-center
#4
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...
March 7, 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
#5
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/28259479/-management-of-mesenteric-ischemia-in-the-era-of-intestinal-stroke-centers-the-gut-and-lifesaving-strategy
#6
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
https://www.readbyqxmd.com/read/28242089/inhalation-of-methane-preserves-the-epithelial-barrier-during-ischemia-and-reperfusion-in-the-rat-small-intestine
#7
András T Mészáros, Tamás Büki, Borbála Fazekas, Eszter Tuboly, Kitti Horváth, Marietta Z Poles, Szilárd Szűcs, Gabriella Varga, József Kaszaki, Mihály Boros
BACKGROUND: Methane is part of the gaseous environment of the intestinal lumen. The purpose of this study was to elucidate the bioactivity of exogenous methane on the intestinal barrier function in an antigen-independent model of acute inflammation. METHODS: Anesthetized rats underwent sham operation or 45-min occlusion of the superior mesenteric artery. A normoxic methane (2.2%)-air mixture was inhaled for 15 min at the end of ischemia and at the beginning of a 60-min or 180-min reperfusion...
February 24, 2017: Surgery
https://www.readbyqxmd.com/read/28235651/ascending-aorta-common-hepatic-artery-bypass-for-mesenteric-revascularization
#8
Yuri Murakami, Naoki Toya, Soichiro Fukushima, Eisaku Ito, Tadashi Akiba, Takao Ohki
INTRODUCTION: Chronic aortic occlusion usually occurs from the infrarenal branch to the terminal aorta. We report the case of a patient with an occlusion that began at the suprarenal artery, and there was also occlusion of the superior mesenteric artery and extreme stenosis of the celiac artery. Antegrade bypass from the ascending aorta to the common hepatic artery was performed. PRESENTATION OF CASE: A 59-year-old patient presented to our hospital with uremia due to acute anuric renal failure and anorexia...
February 3, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28209089/regarding-management-of-acute-mesenteric-ischemia-a-critical-review-and-treatment-algorithm
#9
Zhongzhi Jia, Feng Tian, Guomin Jiang
No abstract text is available yet for this article.
February 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28195969/acute-mesenteric-ischemia-among-postcardiac-surgery-patients-presenting-with-multiple-organ-failure
#10
Alexis Guillaume, Sébastien Pili-Floury, Sidney Chocron, Eric Delabrousse, Bénédicte De Parseval, Stephane Koch, Emmanuel Samain, Gilles Capellier, Gaël Piton
BACKGROUND: Acute mesenteric ischemia (AMI) is a rare but severe complication after cardiac surgery. However, AMI is likely to be more frequent in the subgroup of patients presenting with multiple organ failure after a cardiac surgery. The primary objective of this study was to identify AMI risk factors among patients requiring intensive care unit (ICU) admission after cardiac surgery. METHODS: Retrospective observational study of all the patients requiring admission to two ICUs in a large university hospital after a cardiac surgery procedure...
March 2017: Shock
https://www.readbyqxmd.com/read/28162216/-gradient-treatment-of-acute-superior-mesenteric-venous-thrombosis-clinical-analysis-of-68-cases
#11
K Liu, X X Fan, S F Yang, W W Ding, C S He, X J Wu, J S Li
Objective: To investigate the effect of Gradient treatment for acute superior mesenteric venous thrombosis (ASMVT). Methods: Clinic data of 68 patients of ASMVT admitted in Department of General Surgery, Jinling Hospital, Medical School of Nanjing University from January 2009 to December 2014 were analyzed retrospectively. There were 50 male and 18 female patients with a mean age of (45±12) years. These patients were conducted by the stepwise treatment model (endovascular treatment-damage control surgery-surgical intensive care-intestinal rehabilitation treatment)...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28118796/mechanical-recanalization-for-acute-embolic-occlusion-at-the-origin-of-the-superior-mesenteric-artery
#12
Yoichi Miura, Tomohiro Araki, Mio Terashima, Junya Tsuboi, Yasuhiro Saito, Kenji Kanamaru, Hidenori Suzuki
PURPOSE: We report a combined technique consisting of thrombectomy and thromboaspiration for the treatment of acute embolic occlusion of the superior mesenteric artery (SMA) at the origin. CASE: A 90-year-old female with chronic atrial fibrillation had a sudden onset of abdominal pain and hematochezia due to acute embolic occlusion at the origin of the SMA. Computed tomographic findings showed reversible bowel wall ischemia. We performed mechanical thrombectomy using the Solitaire FR revascularization device, a self-expanding and fully retrievable stent-based thrombectomy system for acute intracranial large artery occlusion, combined with manual aspiration through a 6F guiding sheath placed at the SMA origin via a right brachial approach...
February 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28115983/an-investigation-of-bedside-laparoscopy-in-the-icu-for-cases-of-non-occlusive-mesenteric-ischemia
#13
G Cocorullo, A Mirabella, N Falco, T Fontana, R Tutino, L Licari, G Salamone, G Scerrino, G Gulotta
BACKGROUND: Acute mesenteric ischemia is a rare affection with high related mortality. NOMI presents the most important diagnostic problems and is related with the higher risk of white laparotomy. This study wants to give a contribution for the validation of laparoscopic approach in case of NOMI. METHODS: Thirty-two consecutive patients were admitted in last 10 years in ICU of Paolo Giaccone University Hospital of Palermo for AMI. Diagnosis was obtained by multislice CT and selective angiography was done if clinical conditions were permissive...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28100944/ostomy-in-nontraumatic-conditions-our-experience-and-review-of-the-literature
#14
Kenan Büyükaşık, Bünyamin Gürbulak, Emre Özoran, Yiğit Düzköylü, Esin Kabul Gürbulak, Aziz Arı, Hasan Bektaş
A number of nontraumatic acute abdomen can result in peritonitis leading to sepsis. In emergent conditions, various procedures like segmentary colectomy and/or subtotal colectomy with anastomosis, Hartmann's procedure, transverse colectomy, and/or expandable metallic stent (SEMS) placement can be performed, considering the status of the patient and the facilitaties of the institution. In our study, we examined the cases diagnosed as acute abdomen without the history of trauma, which had lead to a procedure requiring colostomy...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28100127/response-to-management-of-acute-mesenteric-ischemia-a-critical-review-and-treatment-algorithm
#15
Yang Zhao, Henghui Yin, Zilun Li, Guangqi Chang
No abstract text is available yet for this article.
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28099145/down-regulation-of-toll-like-receptor-4-alleviates-intestinal-ischemia-reperfusion-injury-and-acute-lung-injury-in-mice
#16
Qiankun Zhu, Guizhen He, Jie Wang, Yukang Wang, Wei Chen, Tai Guo
Intestinal ischemia reperfusion (IR) injury is a critical problem, which can cause intestinal injury locally and acute lung injury (ALI) distally by inflammatory responses and oxidative stress. Toll-like receptor 4 (TLR4) is involved in innate immune and inflammatory responses. This study was to determine whether TLR4 mutant can attenuate intestinal and lung injuries after intestinal IR. Wild type (WT) and TLR4 mutant mice were submitted to intestinal IR by occluding the superior mesenteric artery. Histological assessment of the intestine and the lung were conducted by HE staining...
January 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/28050424/abdominal-angina-treated-by-urgent-percutaneous-angioplasty-an-excellent-alternative-to-surgical-revascularisation
#17
Vamsi Krishna Kamana, Ranjan Shetty, Anand M Krishnan, M Sudhakar Rao, Umesh Pai Malpe
Chronic Mesenteric Ischemia (CMI) presenting as acute abdomen can be treated percutaneously. An endovascular intervention has surpassed surgical revascularization over the past decade due to its lesser perioperative complication rate. Trans-femoral approach of revascularising is limited by its difficulty in coaxial alignment of the guiding catheter and hence, brachial artery and recently the radial approach have been utilized for mesenteric artery revascularisation for over a decade. Here by we report a case of chronic mesenteric ischemia having total occlusion of two and 70% occlusion of one of the three mesenteric vessels...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28031329/hur-enhances-early-restitution-of-the-intestinal-epithelium-by-increasing-cdc42-translation
#18
Lan Liu, Ran Zhuang, Lan Xiao, Hee Kyoung Chung, Jason Luo, Douglas J Turner, Jaladanki N Rao, Myriam Gorospe, Jian-Ying Wang
The mammalian intestinal mucosa exhibits a spectrum of responses after acute injury and repairs itself rapidly to restore the epithelial integrity. The RNA-binding protein HuR regulates the stability and translation of target mRNAs and is involved in many aspects of gut epithelium homeostasis, but its exact role in the regulation of mucosal repair after injury remains unknown. Here we show that HuR is essential for early intestinal epithelial restitution by increasing the expression of cell division control protein 42 (Cdc42) at the posttranscriptional level...
December 28, 2016: Molecular and Cellular Biology
https://www.readbyqxmd.com/read/28024211/conservative-approach-to-hepatic-portal-venous-gas-a-case-report
#19
G C Ginesu, M Barmina, M L Cossu, C F Feo, A Fancellu, F Addis, A Porcu
INTRODUCTION: Hepatic Portal Venous Gas (HPVG), a rare condition in which gas accumulates in the portal venous circulation, is often associated with a significant underlying pathology, such as Crohn's disease, ulcerative colitis, diverticulitis, pancreatitis, sepsis, intra-abdominal abscess, endoscopic procedures, mesenteric ischemia, abdominal trauma. PRESENTATION OF CASE: Here we report a case of HPVG in an 82-year-old patient who underwent a left colectomy for stenosing tumor of the descending colon...
December 11, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28009224/mesenteric-ischemia-following-the-correction-of-adult-spinal-deformity-case-report
#20
Krishn Khanna, Sigurd H Berven
Vascular complications are an important adverse event that can be associated with spinal reconstructive surgery. Direct injury of vessels, or indirect traction or compression of vessels, can cause both arterial and venous injury. Indirect compression of the mesenteric vessels is a well-recognized complication of bracing and surgical care of children with spinal deformity (superior mesenteric artery syndrome), but the complication is not common or well recognized in the adult population with spinal deformity...
December 23, 2016: Journal of Neurosurgery. Spine
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