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Acute mesenteric ischemia

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https://www.readbyqxmd.com/read/28807407/infrarenal-aorta-as-the-donor-site-for-bypasses-to-the-superior-mesenteric-artery-for-chronic-mesenteric-ischemia-a-prospective-clinical-series-of-24-patients
#1
Giulio Illuminati, Giulia Pizzardi, Francesco G Calio', Rocco Pasqua, Federica Masci, Francesco Vietri
BACKGROUND: Treatment of symptomatic, chronic mesenteric ischemia is indicated to relieve symptoms and prevent acute ischemia and death. Current therapeutic options include endovascular and open surgery. The purpose of this prospective study was to evaluate the results of bypasses to the superior mesenteric artery arising from the infrarenal aorta or infrarenal aortic grafts. METHODS: From January 1999 to December 2016, 24 consecutive patients with a mean age of 61 years underwent a prosthetic bypass to the superior mesenteric artery...
August 11, 2017: Surgery
https://www.readbyqxmd.com/read/28794797/acute-mesenteric-ischemia-guidelines-of-the-world-society-of-emergency-surgery
#2
REVIEW
Miklosh Bala, Jeffry Kashuk, Ernest E Moore, Yoram Kluger, Walter Biffl, Carlos Augusto Gomes, Offir Ben-Ishay, Chen Rubinstein, Zsolt J Balogh, Ian Civil, Federico Coccolini, Ari Leppaniemi, Andrew Peitzman, Luca Ansaloni, Michael Sugrue, Massimo Sartelli, Salomone Di Saverio, Gustavo P Fraga, Fausto Catena
Acute mesenteric ischemia (AMI) is typically defined as a group of diseases characterized by an interruption of the blood supply to varying portions of the small intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process will eventuate in life threatening intestinal necrosis. The incidence is low, estimated at 0.09-0.2% of all acute surgical admissions. Therefore, although the entity is an uncommon cause of abdominal pain, diligence is always required because if untreated, mortality has consistently been reported in the range of 50%...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28792535/occurrence-and-severity-of-non-occlusive-mesenteric-ischemia-nomi-after-cardiovascular-surgery-correlate-with-preoperatively-assessed-fgf-23-levels
#3
Jonas Stroeder, Matthias Klingele, Hagen Bomberg, Stefan Wagenpfeil, Arno Buecker, Hans-Joachim Schaefers, Marcus Katoh, Peter Minko
PURPOSE: To evaluate the value of preoperatively assessed fibroblast growth factor 23 (FGF-23) levels and to correlate FGF-23 with angiographic findings in non-occlusive mesenteric (NOMI) ischemia using a standardized scoring system. MATERIALS AND METHODS: Between 2/2011 and 3/2012 a total of 865 patients (median age: 67 years) underwent cardiovascular surgery during this ethics committee approved, prospective study. 65 of these patients had clinical suspicion of NOMI and consequently underwent catheter angiography of the superior mesenteric artery...
2017: PloS One
https://www.readbyqxmd.com/read/28790275/-management-of-acute-type-a-dissection-complicated-with-acute-mesenteric-ischemia
#4
Tomonobu Abe, Akihiko Usui
Acute mesenteric ischemia as malperfusion syndrome associated with acute aortic dissection is a difficult situation. The incidence is approximately 3~4% in acute type A dissection. Traditionally, most of these patients underwent immediate simple central aortic repair expecting that mesenteric artery obstruction and intestinal ischemia would be resolved by simple central aortic repair. However, short term mortality has been reported very high in this strategy. With the aid of rapidly progressing imaging techniques and newer endovascular repair techniques, results seem to be improving in recent years...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28762450/prognostic-factors-in-acute-mesenteric-ischemia-and-evaluation-with-mannheim-peritonitis-index-and-platelet-to-lymphocyte-ratio
#5
Eyüp Murat Yılmaz, Erdem Barış Cartı
BACKGROUND: Acute mesenteric ischemia (AMI) is a disease that has a very high mortality rate and for which the diagnosis is frequently delayed. The aim of the present study was to assess the predictive value of the Mannheim Peritonitis Index (MPI) and platelet-to-lymphocyte (P/L) ratio in the prognosis of AMI. METHODS: The files of 34 patients diagnosed with AMI between September 2014 and April 2016 were retrospectively examined. The patients were divided into 2 groups based on survival...
July 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28752257/what-is-the-best-revascularization-strategy-for-acute-occlusive-arterial-mesenteric-ischemia-systematic-review-and-meta-analysis
#6
Giancarlo Salsano, Antonio Salsano, Elena Sportelli, Francesco Petrocelli, M'ahmed Dahmane, Giovanni Spinella, Bianca Pane, Simone Mambrini, Domenico Palombo, Francesco Santini
PURPOSE: Acute mesenteric ischemia (AMI) is a life-threatening disease that leads to bowel infarction and death. The optimal management of AMI remains controversial. The present meta-analysis aimed to estimate the prognostic impact of surgical (SG) versus endovascular or hybrid intervention (EV) as the first-line treatment for acute arterial occlusive mesenteric ischemia and to assess whether endovascular strategy was actually effective in reducing bowel resection. METHODS: MEDLINE, Scopus and the Cochrane Library databases were searched...
July 27, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28740960/prognostic-factors-in-patients-with-acute-mesenteric-ischemia
#7
Doğan Yıldırım, Adnan Hut, Cihad Tatar, Turgut Dönmez, Muzaffer Akıncı, Mehmet Toptaş
OBJECTIVE: Acute mesenteric ischemia, one of the causes of acute abdominal pain due to occlusion of the superior mesenteric artery, has a fatal course as a result of intestinal necrosis. There is no specific laboratory test to diagnose acute mesenteric ischemia. The basis of treatment in cases of acute mesenteric ischemia is composed of early diagnosis, resection of intestinal sections with infarction, regulation of intestinal blood flow, second look laparotomy when required, and intensive care support...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28738239/delayed-graft-duodenal-perforation-due-to-impacted-food-five-years-after-simultaneous-pancreas-kidney-transplantation-a-case-report
#8
Taizo Sakata, Hideki Katagiri, Tadao Kubota, Takashi Sakamoto, Kentaro Yoshikawa, Alan Kawarai Lefor, Cheol Woong Jung, Toru Kojima
INTRODUCTION: Pancreas transplantation is the best treatment option in selected patients with type 1 diabetes mellitus. Here we report a patient with a nonmarginal duodenal perforation five years after a simultaneous pancreas-living donor kidney transplantation (SPLKT). PRESENTATION OF CASE: A 31-year old male who underwent SPLKT five years previously presented with severe abdominal pain. He had a marginal duodenal perforation four years later, treated by primary closure and drainage...
July 14, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28733146/resveratrol-efficiently-improves-pulmonary-function-via-stabilizing-mast-cells-in-a-rat-intestinal-injury-model
#9
Xiaolei Huang, Weicheng Zhao, Dan Hu, Xue Han, Hanbin Wang, Jianyu Yang, Yang Xu, Yuantao Li, Weifeng Yao, Chaojin Chen
BACKGROUND: Intestinal ischemia/reperfusion (IIR) leads to acute lung injury (ALI) distally by aggravating pulmonary oxidative stress. Resveratrol is effective in attenuating ALI through its antioxidant capacity. This study aimed to determine the effects of resveratrol on IIR-induced ALI and to explore the role of mast cells (MCs) activation in a rat model of IIR. METHODS: Adult Sprague-Dawley rats were subjected to IIR by occluding the superior mesenteric artery for 60min followed by 4-hour reperfusion...
July 18, 2017: Life Sciences
https://www.readbyqxmd.com/read/28713893/interleukin%C3%A2-6-rna-knockdown-ameliorates-acute-lung-injury-induced-by-intestinal-ischemia-reperfusion-in-rats-by-upregulating-interleukin%C3%A2-10-expression
#10
Bing Yuan, Liu-Lin Xiong, Mu-Dong Wen, Piao Zhang, Hong-Yu Ma, Ting-Hua Wang, Yun-Hui Zhang
Acute lung injury (ALI) is a common complication following intestinal ischemia/reperfusion (II/R) injury and contributes to the associated high mortality rate. However, the underlying mechanism is poorly understood and treatments are limited. RNA interference (RNAi) has been demonstrated to provide a promising disease treatment strategy both in vitro and in vivo. Therefore, the present study aimed to test whether blocking the proinflammatory cytokine IL‑6 by RNAi may protect the lungs from remote organ injury following II/R, and to investigate the potential underlying mechanisms...
September 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28712193/autoimmune-disease-presenting-as-acute-abdomen
#11
Wasim A Memon, Saad Siddiqui, Ameer Hamza
Mesenteric vasculitis and resultant bowel ischemia is rare but serious complication of autoimmune disorders. Early detection and treatment is the key to avoid potentially fatal outcomes of bowel perforation and peritonitis. In this series, we present patients presenting with acute abdominal pain and having CT imaging features of bowel ischemia who responded well to immunosuppressive therapy. The aim of this work is to familiarize health professionals with possibility and imaging features of mesenteric vasculitis...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28710988/intestinal-fatty-acid-binding-protein-level-as-a-predictor-of-28-day-mortality-and-bowel-ischemia-in-patients-with-septic-shock-a-preliminary-study
#12
Motohiro Sekino, Hiroyuki Funaoka, Shuntaro Sato, Kyoko Okada, Haruka Inoue, Rintaro Yano, Sojiro Matsumoto, Taiga Ichinomiya, Ushio Higashijima, Shuhei Matsumoto, Tetsuya Hara
PURPOSE: We sought to evaluate the levels of intestinal fatty acid-binding protein (I-FABP), a biomarker of enterocyte injury, as a predictor of 28-day mortality and bowel ischemia in septic shock patients. MATERIAL AND METHODS: In this preliminary prospective observational study, 57 adult septic shock patients under mechanical ventilation were enrolled. Serum I-FABP levels and prognostic biomarkers were recorded upon intensive care unit (ICU) admission. RESULTS: The overall 28-day mortality rate of participants was 23% (13/57)...
July 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28709648/deficiency-in-cold-inducible-rna-binding-protein-attenuates-acute-respiratory-distress-syndrome-induced-by-intestinal-ischemia-reperfusion
#13
Cindy Cen, Joseph McGinn, Monowar Aziz, Weng-Lang Yang, Joaquin Cagliani, Jeffrey M Nicastro, Gene F Coppa, Ping Wang
BACKGROUND: Intestinal ischemia-reperfusion can occur in shock and mesenteric occlusive diseases, causing significant morbidity and mortality. Aside from local injury, intestinal ischemia-reperfusion can result in remote organ damage, particularly in the lungs. Cold-inducible RNA-binding protein (CIRP) was identified as a novel inflammatory mediator. We hypothesized that a deficiency in CIRP would protect the lungs during intestinal ischemia-reperfusion injury. METHODS: Intestinal ischemia was induced in adult male C57BL/6 wild-type and CIRP knock-out (CIRP(-/-)) mice via clamping of the superior mesenteric artery for 60 minutes...
July 11, 2017: Surgery
https://www.readbyqxmd.com/read/28691670/non-occlusive-mesenteric-ischemia-nomi-in-parkinson-s-disease-case-report
#14
G Salamone, C Raspanti, L Licari, N Falco, G Rotolo, G Augello, G Melfa, G Gulotta
Non-occlusive mesenteric ischemia (NOMI) is a severe pathological condition characterized by signs and symptoms of bowel obstruction, intestinal necrosis resulting from acute and/or chronic inadequate blood perfusion, in the absence of an organic vascular obstruction detectable by imaging techniques. A 64 years old man case with a history of Parkinson's disease in high-functioning levodopa treatment is presented. Clinical and radiological signs of intestinal obstruction were observed. He underwent surgical operation with total colectomy and terminal ileostomy for generalized secondary peritonitis due to perforation of sigmoid colon...
March 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28683785/mesenteric-cysts-and-mesenteric-venous-thrombosis-leading-to-intestinal-necrosis-in-pregnancy-managed-with-laparotomy-a-case-report-and-review-of-the-literature
#15
Aris Giannos, Sofoklis Stavrou, Nikolaos Goumalatsos, George Fragkoulidis, Eleni Chra, Dimitrios Argiropoulos, Dimitrios Loutradis, Peter Drakakis
BACKGROUND: Mesenteric cyst is a rare clinical entity especially in pregnancy; therefore, few cases have been reported in the literature. The standard method of their treatment is surgical excision either with laparotomy or laparoscopy. In addition, mesenteric vein thrombosis is a rare and life-threatening condition in pregnancy and needs immediate treatment because it can lead to intestinal necrotic ischemia. This is the first report of the coexistence of mesenteric cysts and mesenteric vein thrombosis during gestation...
July 7, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28675281/-diagnostic-and-treatment-of-mesenteric-ischemia
#16
Cristina Parliteanu, Mathilde Gavillet, Olivier Gié, Pierre Bize, Michel H Maillard
Mesenteric ischemia results from acute or chronic blood flow reduction in the mesenteric arterial or venous vascular supply. This is usually due to an embolus, thrombosis or intestinal hypoperfusion. Radiologic and / or endoscopic imaging and histology allow for diagnosis in high-risk patients with suggestive clinical symptoms and signs. Treatment aims at preventing multi-organ failure through medical treatment, saving intestinal integrity and resecting necrotic bowel segments. Rapid and multidisciplinary management is key in order to optimize treatment and avoid long-term debilitating consequences...
August 31, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28662085/metabolomic-profiling-to-characterize-acute-intestinal-ischemia-reperfusion-injury
#17
Rachel G Khadaroo, Thomas A Churchill, Victor Tso, Karen L Madsen, Chris Lukowski, Saad Y Salim
Sepsis and septic shock are the leading causes of death in critically ill patients. Acute intestinal ischemia/reperfusion (AII/R) is an adaptive response to shock. The high mortality rate from AII/R is due to the severity of the disease and, more importantly, the failure of timely diagnosis. The objective of this investigation is to use nuclear magnetic resonance (NMR) analysis to characterize urine metabolomic profile of AII/R injury in a mouse model. Animals were exposed to sham, early (30 min) or late (60 min) acute intestinal ischemia by complete occlusion of the superior mesenteric artery, followed by 2 hrs of reperfusion...
2017: PloS One
https://www.readbyqxmd.com/read/28659673/emergency-laparotomies-at-a-tertiary-care-center-a-hospital-based-cross-sectional-study
#18
G Gejoe, Induprabha Yadev, M Rahul
Emergency laparotomy is a common high-risk surgical procedure, but with a few outcome data and few data on postoperative care. This was a hospital-based descriptive study of 376 consecutive emergency midline laparotomies performed in a tertiary care center. The aim of the study was to identify the clinical presentation, surgical indications, preoperative delay, intraoperative findings, and postoperative complications. Majority of the patients belonged to the 40-80-year age group. Broadly, the indications could be divided into acute abdomen and trauma...
June 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28645011/transient-portal-venous-gas-associated-with-reversible-non-occlusive-mesenteric-ischemia-a-case-report
#19
Gaël Piton, Brice Paquette, Eric Delabrousse, Gilles Capellier
OBJECTIVES: To report the utility of abdominal ultrasonography (US) to identify the presence of portal venous gas (PVG) during non-occlusive mesenteric ischemia (NOMI), and to follow the disappearance of portal venous gas after resolution of the NOMI. DATA SOURCES: This was a clinical observation of a patient, with images of abdominal computed tomography (CT), and a video of portal venous gas identified by ultrasonography. DATA SYNTHESIS: We describe the case of an adult patient admitted to our ICU for NOMI developing 48h after cardiac surgery...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28630622/bowel-ischemia-in-icu-patients-diagnostic-value-of-i-fabp-depends-on-the-interval-to-the-triggering-event
#20
Stefan Ludewig, Rami Jarbouh, Michael Ardelt, Henning Mothes, Falk Rauchfuß, René Fahrner, Jürgen Zanow, Utz Settmacher
BACKGROUND: Intestinal fatty acid-binding protein (I-FABP) has been shown to be of high diagnostic value in patients with acute mesenteric ischemia. Whether these results can be reproduced in critically ill patients on the ICU was to be investigated. MATERIALS AND METHODS: I-FABP was measured in serum and urine of 43 critically ill patients in ICU when mesenteric ischemia was suspected. Bowel ischemia was confirmed in 21 patients (group 1). 22 patients who survived at least seven days without confirmation of ischemia were assigned to group 2...
2017: Gastroenterology Research and Practice
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