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ischemic acute intestinal

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https://www.readbyqxmd.com/read/29433829/acute-mesenteric-ischemia-a-critical-role-for-the-radiologist
#1
P Copin, M Zins, A Nuzzo, Y Purcell, S Beranger-Gibert, L Maggiori, O Corcos, V Vilgrain, M Ronot
Acute mesenteric ischemia is defined as an inadequate blood supply to the gastrointestinal tract resulting in ischemic and inflammatory injury that may progress to necrosis of the bowel wall. Prognosis is poor with a mortality rate greater than 95% without treatment, dropping to around 70% when surgical treatment is performed. Contrast-enhanced computed tomography (CT) has become the cornerstone of the diagnosis by showing features of vascular disorders (occlusion and/or insufficient blood supply) and features of intestinal ischemic injury...
February 9, 2018: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/29432382/association-between-macroscopic-tongue-ischemia-and-enterocyte-injury-and-poor-outcome-in-patients-with-septic-shock-a-preliminary-observational-study
#2
Motohiro Sekino, Hiroyuki Funaoka, Shuntaro Sato, Kyoko Okada, Haruka Inoue, Rintaro Yano, Sojiro Matsumoto, Taiga Ichinomiya, Ushio Higashijima, Shuhei Matsumoto, Tetsuya Hara
A correlation between sublingual and intestinal mucosa microcirculation, and ischemic necrosis of the tongue as a sign of poor prognosis has been reported. However, an association between tongue ischemia and intestinal health and subsequent outcome has never been studied. This preliminary prospective observational study evaluated the association between macroscopic tongue ischemia and enterocyte injury and poor outcome in patients with septic shock. In this study, 57 adults with septic shock on mechanical ventilators were enrolled...
February 9, 2018: Shock
https://www.readbyqxmd.com/read/29317943/acute-lower-gastrointestinal-bleeding-characteristics-and-clinical-outcome-of-patients-treated-with-an-intensive-protocol
#3
Georgia Diamantopoulou, Christos Konstantakis, Anastasia Kottorοu, Georgios Skroubis, Georgios Theocharis, Vasileios Theopistos, Christos Triantos, Vasiliki Nikolopoulou, Konstantinos Thomopoulos
Background: In recent years major advances have been made in the management of patients with acute lower gastrointestinal bleeding. The aim of this study was to investigate the characteristics and clinical outcome of patients with acute lower gastrointestinal bleeding (ALGIB) treated with an intensive protocol. Methods: We analyzed the medical records of 528 patients with ALGIB. All patients after hemodynamic stabilization underwent colonoscopy during the first 24 h of hospitalization and capsule enteroscopy when needed...
December 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/29124121/patients-comorbidities-reduce-the-clinical-value-of-emergency-colonoscopy-results-of-a-retrospective-cohort-study
#4
Cristiano Cremone, Anouk Esch, Charlotte Gagniere, Alessandro Fugazza, Faria Mesli, Michael Levy, Aurelien Amiot, Alexis Laurent, Yann LeBaleur, Francois Hemery, Nicolas De'Angelis, Francesco Brunetti, Iradj Sobhani
Background and study aims:  Urgent endoscopy is often used to diagnose and sometimes treat acute upper gastrointestinal syndromes (hemorrhage, toxic ingestion, and occlusion). However, its suitability concerning the management of lower gastrointestinal conditions in emergency circumstances is controversial. Patients and methods:  We studied the role of emergency colonoscopy in diagnosis and treatment of all consecutive patients presenting with acute lower gastrointestinal symptoms referred to our hospital on an emergency basis...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29093588/-complicated-jejunoileal-diverticular-disease-a-12-cases-serie-and-literature-review
#5
Aylhin Joana López Marcano, José Manuel Ramia, Roberto De la Plaza Llamas, Soledad Alonso, Johnny David Gonzales Aguilar, Andree Wolfgang Kühnhardt Barrantes
OBJECTIVE: To perform a retrospective analysis of a series of complicated JID (jejunoileal diverticulitis) cases surgically treated in our service during the period from 2002 to 2015. MATERIALS AND METHODS: We treated 12 cases of jejunoileal complicated diverticulosis. 7 women and 5 men. The mean age was 76 years. The clinical presentation in all cases was acute abdominal pain, one with gastrointestinal bleeding. All cases had leukocytosis, neutrophilia and increased acute phase reactants...
July 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28912818/a-successfully-treated-case-of-gastrointestinal-stromal-tumor-causing-severe-anemia-and-localized-peritonitis-showing-angina-pectoris-resulting-in-watershed-cerebral-infarction
#6
Yoshihide Sehara, Yuka Hayashi, Kenichi Ohya, Naoki Kaneko, Mikio Sawada
Ischemic stroke following acute myocardial infarction is a rare but a serious complication. Because the pathophysiology of stroke is dynamic, it is often hard to identify the cause of stroke. Here, we present the case of a 75-year-old man with ischemic stroke following angina pectoris caused by severe anemia and localized peritonitis due to gastrointestinal stromal tumor of small intestine. On admission, he showed consciousness disturbance, fever, and left hemiplegia. The electrocardiogram on admission showed ST-segment depression in V2 to V6 which was normalized 4 hours later...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28892784/ileal-angiodysplasia-presentation-as-a-bowel-obstruction-a-case-report
#7
Ons Ghdes, Ali Gaja, Ahlem Blel, Hichem Jarraya, Najla Mnif
INTRODUCTION: Angiodysplasia is a common vascular abnormality of the gastrointestinal tract, found in the elderly and most frequently revealed by gastrointestinal bleeding. We report an original case of ileal angiodysplasia in an 83-year-old woman presenting as a bowel obstruction. CASE PRESENTATION: An 83-year-old woman with a medical history of chronic untreated anemia, presented with cardinal symptoms of bowel obstruction. Computed tomography revealed diffuse ileal wall thickening with multiple zones of stenosis, which were aggravated by an ileal perforation and associated with vascular abnormalities compatible with angiodysplasia...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28841570/diagnosis-biomarkers-in-acute-intestinal-ischemic-injury-so-close-yet-so-far
#8
REVIEW
Katell Peoc'h, Alexandre Nuzzo, Kevin Guedj, Catherine Paugam, Olivier Corcos
Acute intestinal ischemic injury (i3) is a life-threatening condition with disastrous prognosis, which is currently difficult to diagnose at the early stages of the disease; a rapid diagnosis is mandatory to avoid irreversible ischemia, extensive bowel resection, sepsis and death. The overlapping protein expression of liver and gut related to the complex physiopathology of the disease, the heterogeneity of the disease and its relative rarity could explain the lack of a useful early biochemical marker of i3...
August 25, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28794797/acute-mesenteric-ischemia-guidelines-of-the-world-society-of-emergency-surgery
#9
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/28691670/non-occlusive-mesenteric-ischemia-nomi-in-parkinson-s-disease-case-report
#10
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/28627342/-baicalein-attenuates-acute-lung-injury-induced-by-intestinal-ischemia-reperfusion-via-inhibition-of-nuclear-factor-%C3%AE%C2%BAb-pathway-in-mice
#11
Lei Chu, Fenyong Zhu, Wenjun Zhou, Zhongxiang Du, Jie Li, Xiaohong Wang, Lihui Wang, Anding Liu
OBJECTIVE: To investigate the effects of baicalein (Bai) on acute lung injury (ALI) induced by intestinal ischemia/reperfusion (I/R) and its mechanism in mice. METHODS: Twenty-four male C57BL/6J mice were divided into three groups by random number table: namely sham group, I/R group and Bai+I/R group, with 8 mice in each group. Intestinal I/R induced lung injury model was reproduced by clamping superior mesenteric artery for 90 minutes, followed by reperfusion. Bai (100 mg/kg) was intraperitoneally injected 1 hour before ischemic challenge in the Bai+I/R group...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625560/small-bowel-ultrasound-beyond-inflammatory-bowel-disease-an-updated-review-of-the-recent-literature
#12
REVIEW
Federica Cavalcoli, Alessandra Zilli, Mirella Fraquelli, Dario Conte, Sara Massironi
The use of bowel ultrasonography (US) for the evaluation of gut diseases has increased in recent years and has been proven to provide a widely available, non-invasive and inexpensive method for the initial work-up and follow-up of different intestinal diseases, limited mostly by technical challenges posed by the patient's anatomy. The present review aims to provide an extensive overview of the main pathologic features at US examination of intestinal diseases other than inflammatory bowel disease, both acute (e...
June 15, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28614987/role-of-amino-acid-supplementation-in-the-prevention-of-necrotizing-enterocolitis-in-preterm-neonates-a-review-of-current-evidences
#13
Bhawan Deep Garg, Nandkishor S Kabra
BACKGROUND: Necrotizing enterocolitis (NEC) is one of the most common acute and fatal gastrointestinal emergency in very low birth weight (VLBW) preterm neonates with mortality range from 15 to 30%. NEC is likely due to multifactorial process such as oxidative injury, ischemic necrosis, and over-reactive inflammatory response to intestinal microbes. AIMS: To evaluate the role of amino acid supplementation for reduction of neonatal NEC in preterm neonates. METHOD: The literature search was done for various randomized control trial (RCT) by searching the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, Scopus, Index Copernicus, African Index Medicus (AIM), Thomson Reuters (ESCI), Chemical Abstracts Service (CAS) and other database...
June 30, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28612169/diagnostic-value-of-arterial-blood-gas-lactate-concentration-in-the-different-forms-of-mesenteric-ischemia
#14
A Brillantino, F Iacobellis, A Renzi, R Nasti, L Saldamarco, M Grillo, L Romano, M Castriconi, A Cittadini, M De Palma, M Scaglione, N Di Martino, R Grassi, F Paladino
PURPOSE: The role of serum lactate measurement in patients with intestinal ischemia still remains unclear. The aim of this study was to prospectively evaluate the diagnostic performance of arterial blood gas lactate concentrations in the patients with acute mesenteric ischemia and its different forms. METHODS: All the patients reporting abdominal pain associated with risk factors for mesenteric ischemia underwent arterial blood gas and contrast enhanced abdominal computer tomography (CT)...
June 13, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28599264/time-series-analysis-of-heat-waves-and-emergency-department-visits-in-atlanta-1993-to-2012
#15
Tianqi Chen, Stefanie E Sarnat, Andrew J Grundstein, Andrea Winquist, Howard H Chang
BACKGROUND: Heat waves are extreme weather events that have been associated with adverse health outcomes. However, there is limited knowledge of heat waves' impact on population morbidity, such as emergency department (ED) visits. OBJECTIVES: We investigated associations between heat waves and ED visits for 17 outcomes in Atlanta over a 20-year period, 1993-2012. METHODS: Associations were estimated using Poisson log-linear models controlling for continuous air temperature, dew-point temperature, day of week, holidays, and time trends...
May 31, 2017: Environmental Health Perspectives
https://www.readbyqxmd.com/read/28525410/sm22-a-plasma-biomarker-for-human-transmural-intestinal-ischemia
#16
Dirk H S M Schellekens, Kostan W Reisinger, Kaatje Lenaerts, M'hamed Hadfoune, Steven W Olde Damink, Wim A Buurman, Cornelis H C Dejong, Joep P M Derikx
OBJECTIVE: To evaluate the diagnostic potential of smooth muscle protein of 22 kDa (SM22) as plasma biomarker for the detection of transmural intestinal ischemia. BACKGROUND: Acute mesenteric ischemia is an abdominal emergency requiring rapid diagnosis and treatment. Especially, detection of transmural damage is imperative because it mandates emergency surgery. Since early clinical and radiological signs are nonspecific, there is an urgent need for accurate biomarkers...
May 18, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28323233/iloprost-use-in-patients-with-persistent-intestinal-ischemia-unsuitable-for-revascularization
#17
Alexandre Nuzzo, Damien Soudan, Lore Billiauws, Julie Bataille, Léon Maggiori, Maxime Ronot, Jeanick Stocco, Yoram Bouhnik, Yves Castier, Olivier Corcos
BACKGROUND: 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. 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 18, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28266590/predictive-factors-of-intestinal-necrosis-in-acute-mesenteric-ischemia-prospective-study-from-an-intestinal-stroke-center
#18
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...
April 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28259479/-management-of-mesenteric-ischemia-in-the-era-of-intestinal-stroke-centers-the-gut-and-lifesaving-strategy
#19
REVIEW
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...
September 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28072691/the-effectiveness-and-safety-of-dual-antiplatelet-therapy-in-ischemic-cerebrovascular-disease-with-intracranial-and-extracranial-arteriostenosis-in-chinese-patients-a-randomized-and-controlled-trail
#20
RANDOMIZED CONTROLLED TRIAL
Feng-Tong Zuo, Hui Liu, Hui-Jun Wu, Na Su, Jie-Qiong Liu, Ai-Qin Dong
BACKGROUND: There are limited data on the effect of dual antiplatelet treatment with clopidogrel plus aspirin in patients with ischemic cerebrovascular disease and intracranial and extracranial arteriostenosis. The aim of our study was to evaluate the efficacy and safety of aspirin plus clopidogrel in the treatment of ischemic cerebrovascular disease with intracranial and extracranial arteriostenosis. METHODS: Patients with clinically evident acute cerebral infarction or transient ischemic attack combined with intracranial and extracranial arteriostenosis (greater than 50%) who were unsuitable or reluctance to perform stent implantation were enrolled in this study...
January 2017: Medicine (Baltimore)
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