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Mesenteric ischaemia

Shokei Matsumoto, Atsuhi Shiraishi, Mitsuaki Kojima, Hiroyuki Funaoka, Tomohiro Funabiki, Takafumi Saida, Mitsuhide Kitano
BACKGROUND: Nonocclusive mesenteric ischemia (NOMI) is an acute and life-threatening gastrointestinal disorder, requiring rapid therapeutic intervention for ischemic bowel. However, its rapid detection remains challenging. This retrospective, observational study was aimed at comparing the diagnostic accuracy for NOMI in models of biomarkers, including intestinal fatty acid-binding protein (I-FABP), and clinical findings. METHODS: All consecutive patients who presented to the emergency department of the study hospital with suspected NOMI were prospectively enrolled...
October 29, 2018: Journal of Trauma and Acute Care Surgery
Chih-Yao Chiang, Chen-Yen Chien, Wei-Yin Qiou, Christopher Chang, I-Shing Yu, Po-Yuan Chang, Chiang-Ting Chien
OBJECTIVE:  Activation of thromboxane A2 synthase (TXAS)/thromboxane A2 (TXA2 )/thromboxane prostanoid (TP) receptor leads to arterial constriction, platelet aggregation and vascular injury. We attempted to characterize the microvascular dysfunction in ischaemia/reperfusion injury using genetically modified TXAS-/- , TP-/- and TXAS-/- TP-/- mice. APPROACH AND RESULTS:  The cardiac micro-circulation and electrocardiograms were evaluated from B6, TXAS-/- , TP-/- and TXAS-/- TP-/- mice in response to intravenous saline, endothelin-1, U46619 (a TXA2 agonist) and myocardial ischaemia/reperfusion injury...
November 2018: Thrombosis and Haemostasis
Iannis Ben Abdallah, Pierre Cerceau
No abstract text is available yet for this article.
November 2018: European Journal of Vascular and Endovascular Surgery
Michael G Fadel, Brian Andrews
Acute mesenteric ischaemia is a relatively rare surgical emergency, but despite advances in diagnostic tests, the mortality of this condition remains stubbornly high (50%-80%). This is principally because of the non-specific nature of the presenting symptoms and subsequent delay in diagnosis. We report an unusual case of acute mesenteric ischaemia treated by emergency laparotomy, small bowel resection and revascularisation using reversed long saphenous vein graft.
September 30, 2018: BMJ Case Reports
Baochen Liu, Chengnan Chu, Xinxin Fan, Weiwei Ding, Xingjiang Wu
BACKGROUND: Isolated superior mesenteric artery dissection (ISMAD) is rare, especially when associated with intestinal ischaemia. We report our clinical experience managing this condition. PATIENTS AND METHODS: Medical records from 22 patients with ISMAD and intestinal ischaemia were retrospectively analysed. Conservative treatment was given to all patients as first line therapy. Subsequently, 15 patients received endovascular stent placement and three patients received endovascular stent placement plus intestinal resection and anastomosis...
September 19, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Maria Antonietta Mazzei, Francesco Gentili, Francesco Giuseppe Mazzei, Roberto Grassi, Luca Volterrani
No abstract text is available yet for this article.
October 4, 2018: British Journal of Radiology
Rasmus Ahlfors, Dana Jensen
Wilkie's syndrome is a rare condition in which a decreased angle and distance between the superior mesenteric artery and aorta causes a compression of the third part of the duodenum, resulting ultimately in gastric dilation, gastric rupture and acute ischaemia of the bowel. The early symp-toms are those of duodenal obstruction. It is clinically char-acteristic, easily recognised on diagnostic imaging and is treated either conservatively or surgically. Although rare, Wilkie's syndrome is associated with severe morbidity, and should be considered in patients presenting with abdominal pain...
September 3, 2018: Ugeskrift for Laeger
Kyriakos Oikonomou, Piotr Kasprzak, Athanasios Katsargyris, Pablo Marques De Marino, Karin Pfister, Eric L G Verhoeven
OBJECTIVES: Patients surviving acute aortic dissection are at risk of developing a post-dissection thoraco-abdominal aortic aneurysm (PD-TAAA) during follow up, regardless of the type of treatment in the acute setting. Fenestrated and branched stent grafting (F/B-TEVAR) has been used with success to treat PD-TAAA, albeit reported only with short-term results. The aim of this study was to report mid-term results in a cohort of 71 patients. METHODS: This was a retrospective analysis of a prospectively maintained database including all patients with PD-TAAAs who underwent F/B-TEVAR within the period January 2010 - April 2017 at two vascular institutions experienced in endovascular techniques...
September 1, 2018: European Journal of Vascular and Endovascular Surgery
Alexander Greenhough, Clare Bagley, Kate J Heesom, David B Gurevich, David Gay, Mark Bond, Tracey J Collard, Chris Paraskeva, Paul Martin, Owen J Sansom, Karim Malik, Ann C Williams
Hypoxia is a hallmark of solid tumours and a key physiological feature distinguishing cancer from normal tissue. However, a major challenge remains in identifying tractable molecular targets that hypoxic cancer cells depend on for survival. Here, we used SILAC-based proteomics to identify the orphan G protein-coupled receptor GPRC5A as a novel hypoxia-induced protein that functions to protect cancer cells from apoptosis during oxygen deprivation. Using genetic approaches in vitro and in vivo , we reveal HIFs as direct activators of GPRC5A transcription...
November 2018: EMBO Molecular Medicine
S Florim, A Almeida, D Rocha, P Portugal
Acute mesenteric ischaemia (AMI) is an uncommon cause of acute hospital admission with high mortality rates (50-90%) that requires early diagnosis and treatment. With the increase in average life expectancy, AMI represents one of the most threatening abdominal conditions in elderly patients. Untreated, AMI will cause mesenteric infarction, intestinal necrosis, an overwhelming inflammatory response and death. Early intervention can reverse this process leading to a full recovery, but the diagnosis of AMI is difficult...
October 2018: Insights Into Imaging
Janet P Baxter, Peter M Fayers, Federico Bozzetti, Darlene Kelly, Francisca Joly, Geert Wanten, Cora Jonkers, Cristina Cuerda, Andre van Gossum, Stanislaw Klek, Marie-France Boudreault, Alain Gilbert, Manon Jobin, Michael Staun, Lyn Gillanders, Alastair Forbes, Margie O'Callaghan, Ceferino Martínez Faedo, Cinzia Brunelli, Luigi Mariani, Loris Pironi
BACKGROUND & AIMS: Home parenteral nutrition-quality of life (HPN-QOL© ) is a self-assessment tool for the measurement of QOL in patients on HPN. The aims of this study were: to re-assess the basic psychometric properties of the HPN-QOL© in a multinational sample of adult patients; to provide a description of QOL dimensions by short and long HPN treatment duration; to explore clinical factors potentially associated to QOL scores. METHODS: Patients (n = 699) from 14 countries completed the HPN-QOL© ...
August 6, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
A Bond, A Teubner, M Taylor, C Cawley, J Varden, A Abraham, P R Chadwick, M Soop, G L Carlson, S Lal
INTRODUCTION: The management of intestinal failure (IF) requires safe and sustained delivery of parenteral nutrition (PN). The long-term maintenance of central venous catheter (CVC) access is therefore vital, with meticulous catheter care and salvage of infected CVCs being of prime importance. CVC-related infection and loss of intravenous access are important causes of morbidity and mortality in IF. Avoidance, prompt recognition and appropriate management of CVC-related infections are crucial components of IF care...
July 27, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
John Hunninghake, Brian Patrick Murray, David Ferraro, John Gancayco
We report the case of a 23-year-old woman who presented with bloody diarrhoea and multiple syncopal events. While the initial diagnosis clinically appeared to be inflammatory bowel disease, she was found to have a portal vein thrombosis (PVT) on MR cholangiopancreatography and acute intestinal ischaemia on colonic biopsy. The aetiology of this patient's PVT is attributed to her acquired prothrombotic state from an estrogen-containing contraceptive pill in conjunction with regular tobacco use. Extensive mesenteric venous thrombosis from an acute PVT has been shown to cause intestinal ischaemia, likely from venous obstruction and reflexive arterial constriction; however, the diagnosis is often delayed until surgery or autopsy...
August 4, 2018: BMJ Case Reports
Lucy D Miller, Nicholas J Hilliard, Simon J F Harper
Introduction: Superior mesenteric arteriovenous fistulae (SMAVF) are rare, usually secondary to trauma or iatrogenic injury and typically present sometime after the initial insult. Report: A 30 year old male underwent immediate laparotomy for abdominal gunshot injury. The small bowel mesentery contained a large haematoma and a palpable thrill. CT demonstrated a large SMAVF. At re-look laparotomy, small bowel ischaemia was noted and following this endovascular SMA stent graft insertion was performed, with excellent angiographic and clinical results...
2018: EJVES Short Reports
Steven Maximus, Ross Milner
No abstract text is available yet for this article.
2018: EJVES Short Reports
Stanislaw Klek, Kinga Szczepanek, Lucyna Scislo, Elzbieta Walewska, Magdalena Pietka, Magdalena Pisarska, Michal Pedziwiatr
AIM: Intravenous lipid emulsion (ILE) can become a risk factor for intestinal failure associated liver disease (IFALD). Many ILEs are commercially available, however, a direct comparison of their impact on liver has, to our knowledge, never been performed. The aim of the study was to analyse that clinical problem during long term parenteral nutrition (PN). METHODS: A randomized, controlled clinical trial was performed at the Intestinal Failure Center in Skawina, Poland...
November 2018: Nutrition
S Balakrishnan, S Kapoor, P Vijayanath, H Singh, A Nandhakumar, K Venkatesulu, V Shanmugam
Coeliac artery stenosis (CAS) is rarely of consequence owing to rich collateral supply from the superior mesenteric artery via the pancreatic head. Pancreaticoduodenectomy (PD) in CAS disrupts these collaterals, and places the liver, stomach and spleen at risk of ischaemia. A 56-year-old man presented with a 3-week history of obstructive jaundice. Computed tomography revealed an operable periampullary tumour with CAS due to compression by the median arcuate ligament with multiple collaterals in the pancreatic head and a prominent gastroduodenal artery (GDA)...
September 2018: Annals of the Royal College of Surgeons of England
Paula R Keschenau, Shirley Ketting, Barend Mees, Mohammad E Barbati, Jochen Grommes, Alexander Gombert, Geert Willem H Schurink, Drosos Kotelis, Michael J Jacobs
OBJECTIVE: The aim was to present current results of open thoracic and thoraco-abdominal aortic repair as secondary procedure after prior endovascular therapy. METHODS: This was a retrospective cross border single centre study. From 2006 to July 2017 45 open thoracic aortic (TAA) or thoraco-abdominal aortic aneurysm (TAAA) operations were performed on 44 patients (median age 58 [15-80] years) as secondary surgery after previous endovascular therapy comprising TEVAR (n = 38; 86%), EVAR (n = 3; 7%), fenestrated EVAR (n = 1; 2%) and TEVAR plus EVAR (n = 1; 2%)...
July 2018: European Journal of Vascular and Endovascular Surgery
António Cruz Tomás, Álvaro Laranjeira Santos, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: The Frozen Elephant Trunk (FET) surgery allows correction of ascending, arch and proximal descending aortic pathology, using a hybrid prosthesis at the same time. It is a complex intervention and requires a multidisciplinary team that, besides scheduling and performing the surgery, accompanies the patient (pt) throughout the postoperative period. OBJECTIVES: To review short and medium term clinical results with this technique. METHODS: Between January 2010 and September 2017, we operated 34 patients (pts) using FET...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
D Y-F Chung, E M Anderson
AIM: To evaluate the use of a single-pass with biphasic intravenous contrast medium injection computed tomography (CT) protocol to provide diagnostic quality CT studies for the assessment of complications post-simultaneous pancreas-kidney transplant (SPK). MATERIALS AND METHODS: This was an audit of practice and the need for informed consent was waived. The protocol was used in consecutive patients undergoing CT to exclude intra-abdominal sepsis post-SPK between June and December 2015...
July 2018: Clinical Radiology
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