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Mesenteric ischemia

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https://www.readbyqxmd.com/read/28655067/fatal-ulcerative-enteritis-of-the-small-intestine-in-a-patient-with-ulcerative-colitis-treated-with-vedolizumab
#1
Carmen Monasterio, Annette Schmitt-Gräff, Matthias Pohl, Thomas Truschel, Klaus Warnatz, Wolfgang Kreisel, Robert Thimme, Peter Hasselblatt
Vedolizumab (VDZ) inhibits α4β7 integrins and is used to target intestinal immune responses in patients with inflammatory bowel disease, which is considered to be relatively safe. Here we report on a fatal complication following VDZ administration. A 64-year-old female patient with ulcerative colitis (UC) refractory to tumor necrosis factor inhibitors was treated with VDZ. One week after the second VDZ infusion, she was admitted to hospital with severe diarrhea and systemic inflammatory response syndrome (SIRS)...
June 27, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28645011/transient-portal-venous-gas-associated-with-reversible-non-occlusive-mesenteric-ischemia-a-case-report
#2
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...
June 16, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28638005/sclerosing-mesenteritis-causing-chylous-ascites-and-small-bowel-perforation
#3
Huei-Wen Lim, Keith S Sultan
BACKGROUND Sclerosing mesenteritis (SM) is a rare idiopathic inflammation and fibrosis of the mesentery. Its etiology and pathogenesis remain unclear. It has been linked to abdominal trauma related to peritoneal dialysis, recent abdominal surgery, idiopathic inflammatory disorder, paraneoplastic syndrome, ischemia/infection, and autoimmunity. Abdominal CT is the most sensitive imaging modality, and diagnosis is usually confirmed by surgical biopsy. Patients most often present with abdominal pain, nausea, vomiting, diarrhea, and weight loss, and less commonly with chylous ascites and small bowel obstruction...
June 22, 2017: American Journal of 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
#4
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
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
#5
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/28627188/effect-of-glutamine-on-liver-injuries-induced-by-intestinal-ischemia-reperfusion-in-rats
#6
Renata Hartmann, Francielli Licks, Elizângela Gonçalves Schemitt, Josieli Raskopf Colares, Juliana Da Silva, Rosa Maria Moura, Gilmara Pandolfo Zabot, Henrique Sarubbi Fillmann, Norma Possa Marroni
INTRODUCTION: Intestinal ischemia-reperfusion (I/R) injury may cause cell and tissue damage, reaching also other organs such as the liver. Because of the involvement of free radicals in I/R injury, treatment options with antioxidants have been studied and tested. OBJECTIVE: To evaluate the effect of glutamine (Gln) in the liver of animals with intestinal I/R injury. METHODS: We used 20 male Wistar rats divided into four groups: sham-operated (SO); glutamine + sham-operated (G+SO); intestinal ischemia-reperfusion (I/R); glutamine + intestinal ischemia-reperfusion (G+I/R)...
June 5, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/28615071/survivin-expression-pattern-in-the-intestine-of-normoxic-and-ischemic-rats
#7
Alexandra Scheer, Shirley K Knauer, Rabea Verhaegh
BACKGROUND: Survivin, a member of the inhibitor of apoptosis protein (IAP) family, regulates mitosis and chromosome segregation. The expression of survivin proceeds during embryonic development and in addition has already been demonstrated in cancer cells. However, there is also evidence of survivin expression in differentiated tissues, including the gastro-intestinal tract of adult rats. A study with human colon specimens exhibited survivin in most basal crypt epithelial cells of normal mucosa...
June 14, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28612169/diagnostic-value-of-arterial-blood-gas-lactate-concentration-in-the-different-forms-of-mesenteric-ischemia
#8
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/28611868/gastrointestinal-tract-amyloidosis-presenting-with-pneumatosis-intestinalis
#9
Vikram Raghunathan, David Louis, Baldeep Wirk
Pneumatosis intestinalis is a radiographic finding of gas pockets within the bowel wall. It can be associated with a range of diagnoses, but the most life-threatening causes are mesenteric ischemia, bowel necrosis, and bowel obstruction. Here we present the case of a patient with multiple myeloma who had pneumatosis intestinalis due to gastrointestinal amyloidosis, which is a rare manifestation of systemic amyloid disease. The patient had both transthyretin (ATTR) amyloidosis and acquired apolipoprotein serum amyloid A (AA) amyloidosis that are not usually seen in conjunction with multiple myeloma, which is most commonly associated with light-chain (AL) amyloidosis...
July 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28602156/fractured-superior-mesenteric-artery-stent-with-stent-displacement-leading-to-recurrent-symptoms-of-superior-mesenteric-ischemia
#10
Robert Juszkat, Michał Klimont, Magdalena Śliwa, Zbigniew Krasiński
We report a case of a patient with recurrent symptoms of superior mesenteric ischemia 7 months after successful percutaneous angioplasty and implantation of a stent in the superior mesenteric artery (SMA). Stent fracture and stent displacement were observed. To the best of our knowledge, this is the first report of SMA stent fracture with stent displacement.
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28601336/lipid-rich-enteral-nutrition-controls-intestinal-inflammation-improves-intestinal-motility-and-mucosal-barrier-damage-in-a-rat-model-of-intestinal-ischemia-reperfusion-injury
#11
Zhi-Liang Lin, Shan-Jun Tan, Min-Hua Cheng, Chen-Yan Zhao, Wen-Kui Yu, Yu-Long He, Jieshou Li, Ning Li
BACKGROUND: It has been reported that lipid-rich enteral nutrition (EN) could ameliorate inflammation in various diseases. In this study, we investigated whether lipid-rich EN could control intestinal inflammation, improve intestinal motility and mucosal barrier injury after intestinal ischemia/reperfusion (I/R) injury. METHODS: Male adult rats received saline, conventional EN, or lipid-rich EN via gavage before and after intestinal I/R injury. The superior mesenteric artery was occluded for 60 min...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601326/direct-peritoneal-resuscitation-improves-mesenteric-perfusion-by-nitric-oxide-dependent-pathways
#12
Sina Khaneki, Amanda R Jensen, Natalie A Drucker, Troy A Markel
BACKGROUND: Direct peritoneal resuscitation (DPR) has been shown to increase survival after intestinal ischemia and reperfusion injury (I/R). We have previously appreciated that minimum essential medium (MEM), a synthetic cell culture medium with bovine serum, glutamine, and antibiotics, contributes to these benefits. We hypothesized that (1) DPR using MEM as a dialysate would increase mesenteric perfusion, improve intestinal mucosal injury, and limit intestinal and hepatic inflammation after intestinal I/R and (2) these improvements would be dependent on endothelial nitric oxide pathways...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28580527/non-occlusive-mesenteric-ischemia-in-a-patient-with-left-ventricular-assist-device-implantation
#13
Takaaki Samura, Koichi Toda, Daisuke Yoshioka, Hidekazu Takahashi, Shigeru Miyagawa, Yasushi Yoshikawa, Shunsuke Saito, Keitaro Domae, Yoshiki Sawa
Non-occlusive mesenteric ischemia (NOMI) is a devastating complication after cardiac surgery. Once patients develop NOMI, intra-mesenteric infusion of vasodilators and/or emergent laparotomy is usually required, but the mortality is extraordinarily high even with intensive treatment. We present a case of salvage of a patient with NOMI complicated with severe right ventricular dysfunction after left ventricular assist device (LVAD) implantation using maximum treatment with emergent laparotomy and temporary right ventricular assist device implantation...
June 3, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28580043/delayed-small-bowel-perforation-with-findings-of-severe-ischemia-following-blunt-abdominal-trauma
#14
Sehnaz Evrimler, Irfan Okumuser, Deniz Delibas
BACKGROUND: Isolated small bowel perforation following blunt abdominal trauma (BAT) is an uncommon situation with high morbidity and mortality rates, and delayed small bowel perforation is even rarer. The pathophysiology of this condition is not clear in all cases. To the best of our knowledge, this is the first case report of delayed small bowel perforation following BAT with extensive portomesenteric vein gas. CASE REPORT: A 33-year-old male patient was admitted to the emergency department after a car accident...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28579560/role-of-intratubular-pressure-during-the-ischemic-phase-in-acute-kidney-injury
#15
Jin Wei, Jiangping Song, Shan Jiang, Gensheng Zhang, Donald Wheeler, Jie Zhang, Shaohui Wang, En Yin Lai, Lei Wang, Jacentha Buggs, Ruisheng Liu
Acute kidney injury (AKI) induced by clamping of renal vein or pedicle is more severe than clamping of artery, but the mechanism has not been clarified. In the present study, we tested our hypothesis that increased proximal tubular pressure (Pt) during the ischemic phase exacerbates kidney injury and promotes the development of AKI. We induced AKI by bilateral clamping of renal arteries, pedicles, or veins for 18 min at 37°C, respectively. Pt during the ischemic phase was measured with micropuncture. We found that higher Pt was associated with more severe AKI...
June 1, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28559176/results-from-multiple-prospective-single-center-clinical-trials-of-the-off-the-shelf-p-branch-fenestrated-stent-graft
#16
Mark A Farber, Matthew J Eagleton, Tara M Mastracci, James F McKinsey, Raghuveer Vallabhaneni, Björn Sonesson, Nuno Dias, Timothy Resch
OBJECTIVE: The purpose of this study was to report prospective data of an off-the-shelf fenestrated endograft (Zenith p-Branch; Cook Medical, Bloomington, Ind) from four centers for the treatment of patients with pararenal abdominal aortic aneurysms. METHODS: Data were combined from four single-center investigational studies conducted in the United States and Europe. The p-Branch endograft consists of a proximal off-the-shelf component incorporating a scallop for the celiac artery, a superior mesenteric artery fenestration, and two conical pivot fenestrations to preserve flow to the renal vessels...
May 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28533912/portal-vein-thrombosis-in-patients-with-cirrhosis
#17
Leona von Köckritz, Andrea De Gottardi, Jonel Trebicka, Michael Praktiknjo
Portal vein thrombosis (PVT) is frequent in patients with liver cirrhosis and possible severe complications such as mesenteric ischemia are rare, but can be life-threatening. However, different aspects of clinical relevance, diagnosis and management of PVT are still areas of uncertainty and investigation in international guidelines. In this article, we elaborate on PVT classification, geographical differences in clinical presentation and standards of diagnosis, and briefly on the current pathophysiological understanding and risk factors...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28528051/undersized-stent-grafts-for-acute-mesenteric-ischemia-in-chronic-type-b-dissection
#18
Eden C Payabyab, Andrew H Maloney, Derek R Brinster
Acute ischemia in chronic type B dissections carries high rates of morbidity and mortality. A 29-year-old woman with a chronic type B dissection presented with acute abdominal pain. Imaging revealed a worsening dissection with pseudocoarctation causing near complete occlusion of the true lumen by the false lumen. We placed purposefully undersized stent grafts to treat acute mesenteric ischemia by improving true lumen flow. The patient was discharged on postoperative day 4 without adverse events. We suggest that endovascular rescue by placing undersized stent grafts can provide improved flow to the mesenteric vessels with continued false lumen flow to vital organs...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28525410/sm22-a-plasma-biomarker-for-human-transmural-intestinal-ischemia
#19
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/28506911/mangiferin-protects-against%C3%A2-%C3%A2-intestinal-ischemia-reperfusion-induced-%C3%A2-liver-injury-%C3%A2-%C3%A2-involvement-of-ppar-%C3%A2-%C3%AE-gsk-3%C3%AE-and-wnt-%C3%AE-catenin-pathway%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2
#20
Shorouk M El-Sayyad, Ayman A Soubh, Azza S Awad, Hanan S El-Abhar
AIM: Mangiferin (MF), a xanthonoid from Mangifera indica, possesses anti-inflammatory, immunomodulatory, and potent antioxidant effects; however, its protective effect against mesenteric ischemia/reperfusion (I/R)-induced liver injury has not been fully clarified. The study was designed to assess the possible mechanism of action of MF against mesenteric I/R model. MAIN METHODS: Male Wister rats were treated with MF (20mg/kg, i.p) or the vehicle for 3 days before I/R, which was induced by clamping the superior mesenteric artery for 30min followed by declamping for 60min...
May 12, 2017: European Journal of Pharmacology
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