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Mesenteric ischemia

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https://www.readbyqxmd.com/read/29437078/mi-not-a-heart-attack-but-a-gut-attack
#1
Rosemary K Lee, Ana M Cabrera
Mesenteric ischemia and infarction are infrequent but often deadly conditions in acute and critically ill patients. Mesenteric ischemia may be a primary admission diagnosis or may develop secondary to another diagnosis. Having a high index of suspicion for patients at risk of mesenteric ischemia and mesenteric infarction can alter a poor outcome. This article reviews the pathophysiology, risk factors, assessment, medical and nursing diagnoses, as well as collaborative management for mesenteric ischemia. Early identification of patients at risk and the appropriate diagnostic testing are stressed...
February 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29433829/acute-mesenteric-ischemia-a-critical-role-for-the-radiologist
#2
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/29427784/evaluation-of-the-treatment-with-resveratrol-loaded-nanoparticles-in-intestinal-injury-model-caused-by-ischemia-and-reperfusion
#3
Stephanie Carvalho Borges, Paulo Emílio Botura Ferreira, Luisa Mota da Silva, Maria Fernanda de Paula Werner, Juan Manuel Irache, Osvaldo Albuquerque Cavalcanti, Nilza Cristina Buttow
The gastrointestinal tract is extremely sensitive to ischemia and reperfusion (I/R). Studies have reported that resveratrol (RSV) is able to combat damage caused by intestinal I/R. Because of its effectiveness in increasing the permanence and bioavailability of resveratrol in the intestinal epithelium, we investigated whether the effect of resveratrol-loaded in poly(anhydride) nanoparticles reduce oxidative stress and promote myenteric neuroprotection in the ileum of rats subjected to I/R. Physicochemical evaluations were performed on nanoparticles...
February 7, 2018: Toxicology
https://www.readbyqxmd.com/read/29421415/clinical-outcomes-of-total-endovascular-aneurysm-repair-for-aortic-aneurysms-involving-the-proximal-anastomotic-aneurysm-following-initial-open-repair-for-infrarenal-abdominal-aortic-aneurysm
#4
Takeshi Baba, Takao Ohki, Yuji Kanaoka, Koji Maeda, Naoki Toya, Hiroki Ohta, Soichiro Fukushima, Masayuki Hara
PURPOSE: To evaluate initial and midterm clinical outcomes of aortic aneurysms involving the proximal anastomotic aneurysm (AAPAA) following initial open repair for infrarenal abdominal aortic aneurysm. METHODS: Between July 2006 and August 2015, 24 patients underwent elective endovascular repair for the treatment of AAPAAs at our institution. AAPAA classification has been categorized as three types. Type I AAPAA is the most extensive, extending from the descending aorta to the prior proximal anastomosis as similar to Crawford type II or III thoracoabdominal aortic aneurysm (TAAA)...
February 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29419563/a-nonsurgical-approach-to-mesenteric-vascular-disease
#5
Hossein Tabriziani, Armaghan Ahmad, Roberto Bergamaschi, William H Frishman
Mesenteric ischemia is a rare disorder, with considerably high morbidity and mortality rates. It can manifest in several ways, including acute mesenteric ischemia, chronic mesenteric ischemia, nonocclusive mesenteric ischemia, mesenteric venous thrombosis, and colonic ischemia. Of these, acute mesenteric ischemia is the most severe form of intestinal ischemia, with a high mortality rate. The mainstay of therapy for mesenteric ischemia is surgical exploration and resection of infarcted bowel; however, medical therapy can play an important adjunctive role...
March 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29413213/mesenteric-ischemia
#6
REVIEW
Robin M Lawson
Mesenteric ischemia is an uncommon disease most often seen in the elderly. This disease results from blood flow in the mesenteric circulation that inadequately meets metabolic needs of the visceral organs and, if untreated, eventually leads to necrosis of the bowel wall. Mesenteric ischemia is divided into 2 types: acute mesenteric ischemia (AMI) and chronic mesenteric ischemia (CMI). Delayed diagnosis of CMI can lead to AMI. AMI is associated with extremely high mortalities. Early diagnosis via computed tomography angiography and prompt revascularization via endovascular therapy are recommended for symptomatic patients who have not developed bowel ischemia and necrosis...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29395425/improved-mortality-in-treatment-of-patients-with-endovascular-interventions-for-chronic-mesenteric-ischemia
#7
Young Erben, Raymond A Jean, Clinton D Protack, Alex S Chiu, Shirley Liu, Brandon J Sumpio, Samuel M Miller, Bauer E Sumpio
OBJECTIVE: Chronic mesenteric ischemia (CMI) continues to be a devastating diagnosis. There is a national trend toward increased use of endovascular procedures with improved survival for the treatment of these patients. Our aim was to evaluate whether this trend has changed CMI patients' length of hospitalization and health care cost. METHODS: We identified all patients admitted for CMI from the National Inpatient Sample (NIS) from 2000 to 2014. Our primary end points included length of hospital stay (LOS) and cost of hospitalization (COH)...
January 27, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29394646/-two-cases-of-non-occlusive-mesenteric-ischemia-that-developed-after-chemotherapy
#8
Takahiro Wada, Kenji Katsumata, Hiroshi Kuwahara, Takaaki Matsudo, Yusuke Murakoshi, Masatoshi Shigoka, Masanobu Enomoto, Tetsuo Ishizaki, Kazuhiko Kasuya, Akihiko Tsuchida
Non-occlusive mesenteric ischemia(NOMI)causes intestinal necrosis due to irreversible ischemia of the intestinal tract despite the absence of organic obstruction in the mesenteric blood vessels. The disease has extremely poor prognosis. We encountered 2 cases of NOMI hypothesized to have developed after chemotherapy; thus, we report these cases considering the available literature. Case 1: A7 9-year-old man. The patient complained of abdominal pain during the first week after introducing docetaxel for local recurrence of prostate cancer...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29394241/chlorinated-lipids-elicit-inflammatory-responses-in-vitro-and-in-vivo
#9
Hong Yu, Meifang Wang, Derek Wang, Theodore J Kalogeris, Jane McHowat, David A Ford, Ronald J Korthuis
Increased endothelial cell adhesion molecule (ECAM) expression, leukocyte-endothelial cell adhesive interactions (LECA), platelet-endothelial cell adhesion (PECA), mast cell activation, production of reactive oxygen species (ROS), and microvascular permeability are hallmarks of the inflammatory response. The infiltration of inflammatory phagocytes is associated with myeloperoxidase (MPO)-dependent production of hypochlorous acid (HOCl), a reactive chlorinating species (RCS) that targets membrane lipids to produce halogenated lipids such as 2-chlorohexadecanal (2-ClHDA) and 2-chloropalmitic acid (2-ClPA)...
February 1, 2018: Shock
https://www.readbyqxmd.com/read/29387956/predictive-factors-for-intestinal-transmural-necrosis-in-patients-with-acute-mesenteric-ischemia
#10
Sameh Hany Emile
BACKGROUND: Acute mesenteric ischemia (AMI) is a serious and potentially fatal condition. No definite parameter can predict transmural bowel necrosis in patients with AMI to justify early surgical intervention. The current study aimed to identify the clinical, laboratory, and radiologic parameters that can successfully predict the onset of intestinal transmural necrosis in patients with AMI. PATIENTS AND METHODS: Records of patients with AMI in the period of January 2013 to October 2017 were reviewed...
January 31, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29377873/arc-of-riolan-preserving-splenic-flexure-takedown-during-anterior-resection-potentially-critical-to-prevent-acute-anastomotic-ischemia
#11
James Wei Tatt Toh, Ronnie Matthews, Seon-Hahn Kim
INTRODUCTION: The Arc of Riolan is a strategic vessel that provides collateral mesenteric circulation in 10% of individuals. The importance of identifying and preserving the arc of Riolan in reducing the risk of ischemia to the proximal anastomotic segment after high ligation anterior resection was evaluated. TECHNIQUE: The arc of Riolan is a vessel that crosses anterior to the inferior mesenteric vein horizontally below the level of the pancreas. A retrospective review of all recorded videos of laparoscopic and robotic low and ultra-low anterior resections was performed in September to December 2012 and prospective evaluation in April to July 2013...
March 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29358892/emergent-single-balloon-enteroscopy-for-overt-bleeding-of-small-intestinal-vascular-malformation
#12
Chen-Shuan Chung, Kuan-Chih Chen, Yueh-Hung Chou, Kuo-Hsin Chen
A 28-year-old man presented with anemia symptoms and intermittent tarry stool passage for three days. No stigmata of hemorrhage were identified using esophagogastroduodenoscopy, ileocolonoscopy, and contrast-enhanced computed tomography. He then developed massive tarry stool passage with profound hypovolemic shock and hypoxic respiratory failure. Emergent angiography revealed active bleeder, probably from the jejunal branches of the superior mesenteric artery, but embolization was not performed due to possible subsequent extensive bowel ischemia...
January 7, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29350377/melatonin-exhibits-supportive-effects-on-oxidants-and-anastomotic-healing-during-intestinal-ischemia-reperfusion-injury
#13
Namık Özkan, Ömer Faik Ersoy, Zeki Özsoy, Ebru Çakır
BACKGROUND: The aim of this study was to investigate the effects of melatonin on intestinal anastomosis after intestinal ischemia/ reperfusion injury (IRI). METHODS: Thirty Wistar albino rats of both sexes were divided into 3 groups: sham, control, and treatment. IRI was performed by clamping the superior mesenteric artery (SMA) for 30 minutes, followed by reperfusion. The sham rats received only manipulation of the SMA. Melatonin (10 mg/kg) was administered to the treatment group, and the control group was given a vehicle injection...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29349411/takayasu-arteritis-with-middle-aortic-syndrome-and-mesenteric-ischemia-treated-by-aortic-stenting
#14
Sarah Morrissey, Kong Teng Tan, John Stephen Byrne
A 48-year-old woman suffering from Takayasu arteritis presented with middle aortic syndrome consisting of abdominal pain, refractory hypertension with pulmonary edema and pleural effusions, and lower limb ischemia. She failed to improve with high-dose steroid therapy and underwent endovascular stenting of two severe stenoses in the supraceliac and infrarenal aorta. Her symptoms resolved and hypertension improved after the procedure.
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349407/endovascular-recanalization-of-occluded-superior-mesenteric-artery-using-retrograde-access-through-the-inferior-mesenteric-artery
#15
Eduardo Keller Saadi, Gustavo Oderich, Eduardo Medronha, Rodrigo Petersen Saadi, Marina Petersen Saadi, Cristiano Jaegger
Symptomatic occlusion of the superior mesenteric artery can be treated by open repair, hybrid procedure, or endovascular revascularization. In most cases, endovascular procedures are done by the antegrade approach. We report a case of a 67-year-old woman who presented with acute-on-chronic mesenteric ischemia successfully treated by retrograde endovascular recanalization of an occluded common hepatomesenteric trunk through the inferior mesenteric artery and arc of Riolan.
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29337267/acute-lung-injury-induced-by-intestinal-ischemia-and-reperfusion-is-altered-in-obese-female-mice
#16
Evelyn Thais Fantozzi, Sara Garbin, Fernanda Yamamoto-Ricardo-da-Silva, Ricardo Martins Oliveira-Filho, Domenico Spina, Wothan Tavares-de-Lima, Yanira Riffo-Vasquez
RATIONAL: Acute lung injury (ALI) is a common complication after intestinal ischemia and reperfusion (I/R) injury that can lead to acute respiratory distress syndrome (ARDS). We have previously demonstrated that females are protected against lung damage induced by intestinal I/R through an estrogen mediated mechanism. OBJECTIVES: to investigate the effect of obesity on ALI induced by intestinal I/R in female mice. METHODS: C57Bl/6 female mice were fed with a standard low-fat diet (SD) or a high-fat diet (HFD) for 9 weeks...
January 11, 2018: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29336771/surgical-and-endovascular-management-of-patients-with-chronic-mesenteric-ischemia-a-single-center-experience
#17
Panagiotis Paliogiannis, Giorgio C Ginesu, Alessandro Fancellu, Aldo Pischedda, Mario Maiore, Eleonora Maiore, Antonio Pinna, Michele Barmina, Alberto Porcu
Chronic mesenteric ischemia is a rare intestinal disorder, with a potential evolution toward intestinal infraction. The choice of the appropriate treatment is currently the most crucial issue in the management of patients with chronic mesenteric ischemia. We describe our experience with 16 cases, and we discuss the current diagnostic and therapeutic approaches. A retrospective review of the clinical records was performed, and demographic, clinical, therapeutic, and prognostic data were collected. Six patients were females (37%), and the mean age was 62 years...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29331341/effects-of-the-gut-liver-axis-on-ischemia-mediated-hepatocellular-carcinoma-recurrence-in-the-mouse-liver
#18
Lorenzo A Orci, Stéphanie Lacotte, Vaihere Delaune, Florence Slits, Graziano Oldani, Vladimir Lazarevic, Carlo Rossetti, Laura Rubbia-Brandt, Philippe Morel, Christian Toso
BACKGROUND & AIMS: There is growing evidence that liver graft ischemia-reperfusion (I/R) is a risk factor for hepatocellular carcinoma (HCC) recurrence, but the involved mechanisms are unclear. Here, we tested the hypothesis that mesenteric congestion due to portal blood flow interruption induces endotoxin-mediated Toll-Like Receptor 4 (Tlr4) engagement, resulting in elevated liver cancer burden. We also assessed the role of remote ischemic preconditioning (RIPC) in this context. METHODS: C57Bl/6j mice were exposed to standardized models of liver I/R injury and RIPC, by occluding hepatic and femoral blood vessels...
January 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29322641/case-of-laparoscopic-right-hemicolectomy-for-ascending-colon-cancer-after-aortic-graft-replacement-and-revascularization-of-the-superior-mesenteric-artery
#19
Kiyotaka Hagihara, Hidekazu Takahashi, Norikatsu Miyoshi, Naotsugu Haraguchi, Taishi Hata, Chu Matsuda, Tsunekazu Mizushima, Hirofumi Yamamoto, Yuichiro Doki, Masaki Mori
A 67-year-old man who presented with a bloody stool was diagnosed with ascending colon cancer. He had previously experienced thoracic and abdominal aortic dissections, which were treated with thoracic and abdominal aortic grafts and superior mesenteric artery revascularization. We performed a laparoscopic right hemicolectomy with a D3 lymph node dissection. During the laparotomy, we identified the superior mesenteric artery and an enlarged anterior superior pancreaticoduodenal artery. Injury to the latter artery could lead to severe ischemia in multiple organs; therefore, it was crucial to identify the primary feeding artery and vascular anatomy before and during surgery...
January 11, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29313164/treatment-of-nonocclusive-mesenteric-ischemia-with-type-b-aortic-dissection-using-intra-arterial-catheterization-after-trauma-surgery-case-report
#20
Sho Fujiwara, Yuki Sekine, Ryuichi Nishimura, Kazuya Tadasa, Shukichi Miyazaki
BACKGROUND: Nonocclusive mesenteric ischemia (NOMI) is a mesenteric arterial spasm and intestinal ischemia. This disease is a highly lethal disease because diagnosis and decision of appropriate treatments are often difficult. Operations cannot resolve the spasms and may worsen the situation. However, the safety and effectiveness of catheterization for NOMI with aortic dissection (AD) have not yet been elucidated. Here, we report a successful case of early diagnosis and treatment of NOMI with type B AD involving the superior mesenteric artery (SMA) using the intra-arterial infusion of a vasodilator via the SMA...
January 8, 2018: Surgical Case Reports
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