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Acute mesenteric ischemia

Khaled Elbahrawy, Alaa El-Deeb
BACKGROUND: Acute mesenteric ischemia is a life-threatening vascular emergency that requires early diagnosis, immediate anticoagulation, and intervention to restore mesenteric blood flow adequately. AIMS: To investigate the effect of rectus sheath block (RSB) for postoperative analgesia in patients with mesenteric vascular occlusion. SETTINGS AND DESIGN: Forty patients with mesenteric vascular occlusion, American Society of Anesthesiologists physical status I or II or III, scheduled for laparotomy were enrolled in this study...
September 2016: Anesthesia, Essays and Researches
Kenichiro Sato, Ryo Itagaki, Kenshiro Arao, Kouzou Makita
A 44-year-old man was transported to our hospital with chief complaints of back pain and paralysis of the leg. Contrast-enhanced computed tomography (CT) imaging revealed an acute Stanford B aortic dissection (AD), which was complicated by acute arterial occlusion of the left external iliac artery. The patient was treated by femorofemoral crossover bypass. Thereafter, abdominal pain was noted, and the patient was diagnosed with intestinal ischemia due to occlusion of the celiac artery and superior mesenteric artery (SMA)...
2016: Annals of Vascular Diseases
Alexandre Nuzzo, Olivier Corcos
A 60-year-old man presented with abdominal pain and hypotension. He had recently had thrombosis of the superior mesenteric artery, which required extensive resection of the distal jejunum and ileum. His serum lactate level was 2.6 mmol per liter (normal range, 0.5 to 2.2), and his creatinine level..
October 13, 2016: New England Journal of Medicine
Sheila N Blumberg, Thomas S Maldonado
OBJECTIVE: This review explores the current literature on the natural history, diagnosis, and management of mesenteric venous thrombosis (MVT) in the modern era. METHODS: A review of the contemporary literature from 1997 to 2016 on MVT and its pathogenesis, diagnosis, and treatment was performed. RESULTS: MVT is an insidious and lethal disease associated with acute mesenteric ischemia. The prevalence of MVT has increased sharply during the past two decades commensurate with an increase in radiographic imaging for abdominal complaints...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Jaime Ruiz-Tovar, Pablo Priego
The portal vein is formed by the confluence of the splenic and superior mesenteric veins, which drain the spleen and small intestine respectively. Occlusion of the portal vein by thrombus typically occurs in patients with cirrhosis and/or prothrombotic disorders. However, portal vein thrombosis (PVT) can also happen after determined surgeries. Moreover, PVT can have serious consequences depending on the location and extent of the thrombosis, including hepatic ischemia, intestinal ischemia, portal hypertension… In this chapter, we will review the incidence, management and prophylaxis of PVT after splenectomy, pancreas transplantation, pancreatic surgery and in the setting of acute and chronic pancreatitis...
September 17, 2016: Advances in Experimental Medicine and Biology
P Cuny, M Houot, S Ginisty, S Horowicz, F Plassart, H Mentec, P Eftekhari
INTRODUCTION: The aim of this paper is to underline the need for systematic monitoring of patients treated with anticholinergic antipsychotic drugs. We present the clinical history of a 34-year-old adult, treated with quetiapine in combination with other drugs with anticholinergic effects. CASE REPORT: A 34-year-old male adult had been suffering from bipolar disorder since 2001. He was treated with risperidone, but he was not compliant due to adverse effects, including decreased libido and erectile dysfunction...
September 13, 2016: L'Encéphale
Yusuf Tanrıkulu, Ceren Şen Tanrıkulu, Mehmet Zafer Sabuncuoğlu, Ayetullah Temiz, Furuzan Köktürk, Boran Yalçın
BACKGROUND: Acute mesenteric ischemia (AMI) remains fatal in 50-70% of cases. AMI is recognized as a vascular emergency, requiring rapid and efficient clinical evaluation and treatment. In the present retrospective study, the possible utility of the neutrophil-lymphocyte ratio (NLR) in the early diagnosis of AMI was explored. The potential use of this ratio to distinguish AMI from non-vascular bowel necrosis (NVBN) was investigated. METHODS: A total of 58 AMI, 62 NVBN, and 62 control patients were enrolled between May 1, 2010 and April 30, 2015...
July 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Marco Moschetta, Arnaldo Scardapane, Michele Telegrafo, Nicola Maria Lucarelli, Valentina Lorusso, Giuseppe Angelelli, Amato Antonio Stabile Ianora
BACKGROUND: Multi-detector computed tomography (MDCT) represents the gold standard in patients with acute abdomen syndrome and suspected bowel ischemia. It provides a correct diagnosis and contributes to appropriate treatment planning. This study aims to evaluate the role of 3D Tissue Transition Projection (TTP) transparent wall CT reconstruction for detecting the degree of bowel dilatation and to correlate this finding with the aetiology and prognosis in patients affected by mesenteric infarction...
August 31, 2016: International Journal of Surgery
Chia-Ying Tseng, Chia-Ming Chang, Shu-Chuan Yang, Julia Chia-Yu Chang, Jen-Dar Chen, Hsien-Hao Huang, Chorng-Kuang How, David Hung-Tsang Yen, Mu-Shun Huang
Objective The purpose of our study was to differentiate the imaging findings of patients with spontaneous intramural intestinal hemorrhage (SIIH) from those with acute mesenteric ischemia (AMI) after abdominal computed tomography (CT) survey in the emergency department. Methods We retrospectively included 83 patients diagnosed with SIIH or AMI after abdominal CT. Results The mean ages of 30 SIIH patients and 53 AMI patients were 74.4±14.6 years and 75.8±11.2 years, respectively. Patients with SIIH had significantly thicker maximal intestinal wall thickening (14...
2016: Internal Medicine
M Praktiknjo, C Meyer, C P Strassburg, J Trebicka
Recent non-cirrhotic and non-malignant splanchnic vein thrombosis is now defined as extrahepatic portal vein thrombosis with or without involvement of the mesenteric vein according to the Baveno VI consensus from 2015. An early diagnosis is often challenging due to unspecific symptoms with abdominal pain or diarrhea but extremely important because of the potential acute and chronic complications, such as mesenteric ischemia and portal hypertension; therefore, rapid treatment is crucial. We present two cases of severe splanchnic vein thrombosis, which were treated with catheter-directed local thrombolysis and thrombus aspiration...
August 29, 2016: Der Internist
Toshihisa Ichiba, Masahiko Hara, Keiji Yunoki, Masaki Urashima, Masao Harano, Hiroshi Naitou, Kouji Yamamoto, Ayumi Shintani
OBJECTIVE: Acute mesenteric ischemia (AMI) is a potentially fatal vascular emergency, and several computed tomographic (CT) findings have been introduced to determine the presence of intestinal ischemia or necrosis, although the most useful finding is unknown. METHODS: We retrospectively analyzed data of 43 consecutive patients with AMI who were treated during the period from 2006 to 2015. Study patients included both superior mesenteric artery dissection (n = 29) and thrombosis (SMAT, n = 14)...
August 12, 2016: American Journal of Emergency Medicine
Bruno Botelho Pinheiro, Walter V Fagundes, Luís F F Muniz, Mats Dreifaldt, Mikael Arbeus, Domingos S R Souza
INTRODUCTION: Optimal surgical management for acute type A aortic dissection (AAAD) remains unclear. The in-hospital mortality rate is still high (15%), and the intraoperative bleeding is an independent risk factor for hospital mortality. OBJECTIVE: The aim of our study was describe a new method for aortic anastomosis in the repair of AAAD and report the hospital mortality and bleeding complications. METHODS: Between January 2008 and November 2014, 24 patients, 16 male, median age 62 years, underwent surgical treatment of AAAD...
April 2016: Brazilian Journal of Cardiovascular Surgery
Saad Y Salim, Pang Y Young, Thomas A Churchill, Rachel G Khadaroo
BACKGROUND: Acute mesenteric ischemia (AMI) has a high morbidity and mortality and often presents as a diagnostic challenge. Currently, there is no blood, urine, or radiologic tests that provide a definitive diagnosis of AMI. The aim of this study was to evaluate the clinical accuracy of urine intestinal fatty acid-binding protein (I-FABP) to diagnosis AMI. MATERIALS AND METHODS: Twenty patients referred to the Acute Care Surgery service at University of Alberta Hospital with suspected AMI taken to the operating room for definitive diagnosis were recruited...
July 16, 2016: Journal of Surgical Research
R Shahverdyan, D Gray, M Gawenda, J Brunkwall
OBJECTIVE: Fenestrated endovascular aneurysm repair (F-EVAR) has increased the number of patients with aneurysmal disease and a short or no existing neck being eligible for endovascular treatment. The aim of the study is to report experience using the Anaconda fenestrated device with special emphasis on target vessel patency and pitfalls with the device. METHODS: Between 2011 and 2016, 48 F-EVAR procedures were performed in 37 males and 11 females under general anaesthesia using the Anaconda custom made device (CMD)...
October 2016: European Journal of Vascular and Endovascular Surgery
Ionuţ Isaia Jeican, Gabriela Ichim, Dan Gheban
The article reviews the intestinal ischemia theme on newborn and children. The intestinal ischemia may be either acute - intestinal infarction (by vascular obstruction or by reduced mesenteric blood flow besides the occlusive mechanism), either chronic. In neonates, acute intestinal ischemia may be caused by aortic thrombosis, volvulus or hypoplastic left heart syndrome. In children, acute intestinal ischemia may be caused by fibromuscular dysplasia, volvulus, abdominal compartment syndrome, Burkitt lymphoma, dermatomyositis (by vascular obstruction) or familial dysautonomia, Addison's disease, situs inversus abdominus (intraoperative), burns, chemotherapy administration (by nonocclusive mesenteric ischemia)...
2016: Clujul Medical (1957)
Tülün Öztürk, Kamil Vural, İbrahim Tuğlu, Ahmet Var, Taner Kurdal, Işıl Aydemir
OBJECTIVE: To evaluate the protective effects of preinjury atenolol (acute v chronic) on apoptosis, contractility, oxidative stress, and inflammatory markers in hypercholesterolemic rats undergoing intestinal ischemia-reperfusion (I/R) injury. DESIGN: Prospective, experimental animal study. SETTING: University laboratory. PARTICIPANTS: Male Wistar rats (n = 32). INTERVENTIONS: Rats were divided into the following 4 groups: 1 group was fed a normal diet (ND) (group ND+NoAT [no atenolol]), and the other 3 groups were fed a high-cholesterol diet (HCD)-group HCD+NoAT, group HCD+ChAT (chronic atenolol, 3 mg/kg/day for 8 weeks), and group HCD+AcAT (acute atenolol, 1...
August 2016: Journal of Cardiothoracic and Vascular Anesthesia
Alexis Guillaume, Sébastien Pili-Floury, Sidney Chocron, Eric Delabrousse, Bénédicte De Parseval, Stephane Koch, Emmanuel Samain, Gilles Capellier, Gaël Piton
BACKGROUND: Acute mesenteric ischemia 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 ICU admission after cardiac surgery. METHODS: Retrospective observational study of all the patients requiring admission to two ICU in a large university hospital after a cardiac surgery procedure...
August 10, 2016: Shock
Tarık Acar, Sedat Koçak, Başar Cander, Mehmet Ergin, Cesareddin Dikmetaş
BACKGROUND/AIM: The purpose of this experimental study was to investigate the role of lipoprotein-associated phospholipase-A2 (Lp-PLA2) in the diagnosis of acute mesenteric ischemia (AMI) in the early stage. MATERIALS AND METHODS: Twenty-seven New Zealand rabbits were randomly divided into 3 groups in this study. Blood specimens were obtained from the groups at hours 0, 1, 3, and 6. Using the blood samples drawn from all groups, Lp-PLA2 and C-reactive protein (CRP) parameters were investigated...
2016: Turkish Journal of Medical Sciences
Hiroki Aoyama, Fumitaka Yanase, Yuji Otsuka, Satoshi Itoh, Homare Okamura
No abstract text is available yet for this article.
March 18, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Giovanni Alemanno, Riccardo Somigli, Paolo Prosperi, Carlo Bergamini, Gherardo Maltinti, Alessio Giordano, Andrea Valeri
INTRODUCTION: Acute mesenteric ischemia is the most severe gastrointestinal complication of acute aortic dissection. The timing of diagnosis is of major importance, in fact the recognition of acute mesenteric ischemia often occurs too late due to the presence of unspecific symptoms and lack of reliable exams. Recently, indocyanine green fluorescence angiography has been adopted in order to measure blood perfusion and microcirculation. PRESENTATION OF CASE: We decided to perform a diagnostic laparoscopy with the support of intra-operative near-infrared indocyanine green fluorescence angiography, in order to detect an initial intestinal ischemia in a 68-year-old patient previously treated with a TEVAR procedure for a type-B aortic dissection...
2016: International Journal of Surgery Case Reports
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