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Acute mesenteric ischemia

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https://www.readbyqxmd.com/read/28050424/abdominal-angina-treated-by-urgent-percutaneous-angioplasty-an-excellent-alternative-to-surgical-revascularisation
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/27986479/prospective-nonrandomized-study-to-evaluate-endovascular-repair-of-pararenal-and-thoracoabdominal-aortic-aneurysms-using-fenestrated-branched-endografts-based-on-supraceliac-sealing-zones
#5
Gustavo S Oderich, Mauricio Ribeiro, Jan Hofer, Jean Wigham, Stephen Cha, Julia Chini, Thanila A Macedo, Peter Gloviczki
PURPOSE: To investigate outcomes of manufactured fenestrated and branched endovascular aortic repair (F-BEVAR) endografts based on supraceliac sealing zones to treat pararenal aortic aneurysms and thoracoabdominal aortic aneurysms (TAAAs). METHODS: A total of 127 patients (91 male, mean age 75 ± 10 years old) were enrolled in a prospective, nonrandomized single-center study using manufactured F-BEVAR (November 2013-March 2015). Stent design was based on supraceliac sealing zone in all patients with ≥ four vessels in 111 (89%)...
December 13, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27974095/occlusive-vasculopathy-in-human-immunodeficiency-virus-hiv-associated-vasculitis-unusual-clinical-and-imaging-course
#6
Enric Ripoll, Sergio Prieto-González, Olga Balagué, Javier Marco-Hernández, Josep M Miró, Anna Darnell, Maria C Cid, José Hernández-Rodríguez
Human immunodeficiency virus (HIV)-associated vasculitis is a rare secondary systemic vasculitis involving medium and small arteries. We report a 42-year-old man with uncontrolled HIV infection presenting with long-lasting abdominal pain. An abdominal CT angiography revealed multiple microaneurysms and stenoses in intrarenal arteries, with involvement of mesenteric and hepatic arteries. HIV-associated vasculitis was diagnosed and glucocorticoids and raltegravir-based antiretroviral therapy were administered with good initial clinical and virological response...
December 14, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27932426/extracorporeal-membrane-oxygenation-for-hemodynamic-support-of-ventricular-tachycardia-ablation
#7
Francesca Baratto, Federico Pappalardo, Teresa Oloriz, Caterina Bisceglia, Pasquale Vergara, John Silberbauer, Nicolò Albanese, Manuela Cireddu, Giuseppe D'Angelo, Ambra Licia Di Prima, Fabrizio Monaco, Gabriele Paglino, Andrea Radinovic, Damiano Regazzoli, Simona Silvetti, Nicola Trevisi, Alberto Zangrillo, Paolo Della Bella
BACKGROUND: We report the experience in a cohort of consecutive patients receiving extracorporeal membrane oxygenation during catheter ablation of unstable ventricular tachycardia (VT) at our center. METHODS AND RESULTS: From 2010 to 2015, extracorporeal membrane oxygenation was initiated in 64 patients (average age: 63±15 years; left ventricular ejection fraction in 27±9%; cardiogenic shock in 23%, and electrical storm in 62% of patients) undergoing 74 unstable VT catheter ablation procedures...
December 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27924419/beneficial-effect-of-low-level-laser-therapy-in-acute-lung-injury-after-i-i-r-is-dependent-on-the-secretion-of-il-10-and-independent-of-the-tlr-myd88-signaling
#8
J L Carvalho, A Britto, A P Ligeiro de Oliveira, H Castro-Faria-Neto, R Albertini, E Anatriello, F Aimbire
The use of low-level laser for lung inflammation treatment has been evidenced in animal studies as well as clinical trials. The laser action mechanism seems to involve downregulation of neutrophil chemoattractants and transcription factors. Innate immune responses against microorganisms may be mediated by toll-like receptors (TLR). Intestinal ischemia and reperfusion (i-I/R) lead to bacterial product translocation, such as endotoxin, which consequently activates TLRs leading to intestinal and lung inflammation after gut trauma...
December 6, 2016: Lasers in Medical Science
https://www.readbyqxmd.com/read/27921277/surgery-for-acute-exacerbation-of-chronic-mesenteric-ischemia-a-case-report
#9
Shinji Abe, Tomoji Yamakawa, Hideaki Kawashima, Makoto Yoshida, Setsuji Takanashi, Motoya Kashiyama, Masahiro Ishigooka, Yasushige Shingu, Yoshiro Matsui
BACKGROUND: Chronic mesenteric ischemia (CMI) is a rare disease; however, symptomatic CMI has a risk of acute exacerbation without timely revascularization. CASE PRESENTATION: A 54-year-old man who had had postprandial pain for 6 months was admitted to our hospital because of vomiting and diarrhea. Although the celiac and superior mesenteric arteries were occluded at the proximal portion, contrast enhancement of the bowel wall was good in contrast-enhanced computed tomography (CECT)...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27901324/acute-mesenteric-ischemia-current-multidisciplinary-approach
#10
Ajay Savlania, Ramesh K Tripathi
The aim of this review is to describe and discuss the mechanisms of acute mesenteric ischemia (AMI) and the rationale and conduct of currently available endovascular and open surgical techniques in its management. We also propose an algorithm to support the current multidisciplinary approach in decision-making for mesenteric revascularization to manage this high-risk entity.
November 30, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27885390/ct-angiography-in-the-setting-of-suspected-acute-mesenteric-ischemia-prevalence-of-ischemic-and-alternative-diagnoses
#11
Frank Oliver Henes, Perry J Pickhardt, Andrzej Herzyk, Scott J Lee, Utaroh Motosugi, Thorsten Derlin, Meghan G Lubner, Gerhard Adam, Gerhard Schön, Peter Bannas
PURPOSE: The purpose of the study was to determine the prevalence of ischemic and alternative diagnoses and the diagnostic accuracy of CT angiography (CTA) in the setting of suspected acute mesenteric ischemia (AMI). MATERIAL AND METHODS: We included 959 patients undergoing CTA for the evaluation of suspected AMI. The final clinical diagnosis was used to determine the prevalence of ischemic and alternative diagnoses and to calculate the diagnostic accuracy of CTA...
November 24, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27858375/diagnosis-of-non-occlusive-acute-mesenteric-ischemia-in-the-intensive-care-unit
#12
Simon Bourcier, Ammar Oudjit, Geoffrey Goudard, Julien Charpentier, Sarah Leblanc, Romain Coriat, Hervé Gouya, Bertrand Dousset, Jean-Paul Mira, Frédéric Pène
BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is a common complication and accounts for a major cause of death in critically ill patients. The diagnosis of NOMI with respect to the eventual indications for surgical treatment is challenging. We addressed the performance of the diagnostic strategy of NOMI in the intensive care unit, with emphasis on contrast-enhanced abdominal CT-scan. METHODS: This was a retrospective monocenter study. Patients with clinically suspected acute mesenteric ischemia were included if a comprehensive diagnostic workup was carried out including surgical and/or endoscopic digestive explorations...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27834292/mesenteric-vascular-dysregulation-and-intestinal-inflammation-accompanies-experimental-spinal-cord-injury
#13
Emily M Besecker, Gina M Deiter, Nicole Pironi, Timothy K Cooper, Gregory M Holmes
Cervical and high thoracic spinal cord injury (SCI) drastically impairs autonomic nervous system function. Individuals with SCI at thoracic spinal level 5 (T5) or higher often present cardiovascular disorders that include resting systemic arterial hypotension. Gastrointestinal (GI) tissues are critically dependent upon adequate blood flow and even brief periods of visceral hypoxia triggers GI dysmotility. The aim of this study was to test the hypothesis that T3-SCI induces visceral hypoperfusion, diminished postprandial vascular reflexes, and concomitant visceral inflammation...
January 1, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/27832292/takayasu-arteritis-ta-first-presenting-with-intestinal-ischemia-a-case-report-and-review-of-gastrointestinal-tract-involvement-ischemic-and-non-ischemic-associated-with-ta
#14
REVIEW
Durga Prasanna Misra, Nagarajan Krishnan, Debasis Gochhait, Dantis Emmanuel, Vir Singh Negi
Takayasu arteritis (TA) is a large vessel vasculitis involving the aorta and its major branches. Insidious inflammation usually results in gradual arterial narrowing; however, critical organ ischemia is rare. We describe a young male with TA who presented with acute mesenteric ischemia requiring intestinal resection, followed by critical limb ischemia. In our literature review, we identified intestinal gangrene as a rare manifestation of TA. However, intestinal ischemia as the first manifestation of TA has been scarcely reported in the literature...
January 2017: Rheumatology International
https://www.readbyqxmd.com/read/27816060/septic-shock-with-no-diagnosis-at-24-hours-a-pragmatic-multicenter-prospective-cohort-study
#15
Damien Contou, Damien Roux, Sébastien Jochmans, Rémi Coudroy, Emmanuel Guérot, David Grimaldi, Sylvie Ricome, Eric Maury, Gaëtan Plantefève, Julien Mayaux, Armand Mekontso Dessap, Christian Brun-Buisson, Nicolas de Prost
BACKGROUND: The lack of a patent source of infection after 24 hours of management of shock considered septic is a common and disturbing scenario. We aimed to determine the prevalence and the causes of shock with no diagnosis 24 hours after its onset, and to compare the outcomes of patients with early-confirmed septic shock to those of others. METHODS: We conducted a pragmatic, prospective, multicenter observational cohort study in ten intensive care units (ICU) in France...
November 6, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27807542/could-mean-platelet-volume-be-a-reliable-indicator-for-acute-mesenteric-ischemia-diagnosis-a-case-control-study
#16
Vermi Degerli, Isil Ergin, Fulya Yilmaz Duran, Mehmet Akif Ustuner, Ozgur Duran
Objective. Acute mesenteric ischemia (AMI) is a disease, usually seen in elderly people and accompanied by comorbid diseases. Mean platelet volume (MPV), the significant indicator of platelet activation and function, is associated with AMI. In this study, we considered that we can use MPV as a reliable indicator in the diagnosis of AMI. Methods. This study was conducted among AMI patients with two control groups. Age, gender, MPV, platelet count, concomitant diseases, abdominal computed tomography, and patient outcomes were recorded for evaluation...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27795815/arterial-complication-of-irreversible-electroporation-procedure-for-locally-advanced-pancreatic-cancer
#17
Yahya Ekici, Tugan Tezcaner, Hüseyin Onur Aydın, Fatih Boyvat, Gökhan Moray
Irreversible electroporation (IRE) is a non-thermal ablation technique used especially in locally advanced pancreatic carcinomas that are considered surgically unresectable. We present the first case of acute superior mesenteric artery (SMA) occlusion secondary to pancreatic IRE procedure that has not been reported before in the literature. A 66-year-old man underwent neoadjuvant chemoradiotherapy for locally advanced pancreatic ductal adenocarcinoma. IRE procedure was applied to the patient during laparotomy under general anesthesia...
October 15, 2016: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27746544/rectus-sheath-block-for-postoperative-analgesia-in-patients-with-mesenteric-vascular-occlusion-undergoing-laparotomy-a-randomized-single-blinded-study
#18
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
https://www.readbyqxmd.com/read/27738474/lifesaving-treatment-of-acute-stanford-b-aortic-dissection-complicated-by-intestinal-ischemia-with-stent-placement-in-the-superior-mesenteric-artery-a-case-report
#19
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
https://www.readbyqxmd.com/read/27732829/reversible-acute-mesenteric-ischemia
#20
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
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