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Mesenteric ischemia

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https://www.readbyqxmd.com/read/29901457/cystic-intestinal-pneumatosis-of-the-small-gut-etiopathogenesis-and-review-of-literature
#1
Luca Napolitano, Mathew Waku, Gustavo Maggi, Franco Ciarelli
Cystic intestinal pneumatosis (CIP) is the presence of gas bubbles inside the wall of the intestine. In literature it has been reported to be associated with a variety of clinical conditions such as: superior mesenteric ischemia, intestinal perforation, bowel necrosis, infections which can cause mucosal alterations and therefore increasing its permeability, necrotizing enterocolitis in babies, trauma, intestinal obstruction, autoimmune and pulmonary pathologies. Its presence is usually documented by radiological techniques such as abdominal X-ray, CT scan and endoscopy and are usually characterized by the typical pattern of gas bubbles in the wall of the intestine...
March 19, 2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29886103/randomized-controlled-trial-of-rivaroxaban-versus-warfarin-in-the-management-of-acute-non-neoplastic-portal-vein-thrombosis
#2
Amr Shaaban Hanafy, Sherief Abd-Elsalam, Mohammed M Dawoud
BACKGROUND AND AIM: Anticoagulation therapy is the main line of treatment for acute portal vein thrombosis (PVT) in the absence of cirrhosis. However, the use of this therapy in cirrhotic PVT is still with doubtful evidence. We aimed to evaluate the efficacy and safety of rivaroxaban compared to warfarin for the management of acute non-neoplastic PVT in Hepatitis C virus (HCV)-related compensated cirrhosis. METHODS: Out of 578 patients with chronic HCV infection, 80 patients with acute PVT who had undergone splenectomy due to hypersplenism and 4 patients with acute PVT due to portal pyemia were selected...
June 7, 2018: Vascular Pharmacology
https://www.readbyqxmd.com/read/29883369/genomics-of-fibromuscular-dysplasia
#3
REVIEW
Silvia Di Monaco, Adrien Georges, Jean-Philippe Lengelé, Miikka Vikkula, Alexandre Persu
Fibromuscular Dysplasia (FMD) is &ldquo;an idiopathic, segmental, non-atherosclerotic and non-inflammatory disease of the musculature of arterial walls, leading to stenosis of small and medium-sized arteries&rdquo; (Persu, et al; 2014). FMD can lead to hypertension, arterial dissections, subarachnoid haemorrhage, stroke or mesenteric ischemia. The pathophysiology of the disease remains elusive. While familial cases are rare (<5%) in contemporary FMD registries, there is evidence in favour of the existence of multiple genetic factors involved in this vascular disease...
May 21, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29881563/a-case-of-extreme-weight-loss-due-to-mesenteric-ischemia-and-antiphospholipid-syndrome
#4
Nikolaos Melas, Amil Haji Younes, Robert Lindberg, Peter Magnusson
Mesenteric ischemia and antiphospholipid syndrome is a rare combination but should be suspected as a differential diagnosis. This may be presented as diffuse abdominal pain typically after food intake, diarrhea, and weight loss. Early recognition is warranted, and nutrition, stenting, and anticoagulant treatments are indicated.
June 2018: Clinical Case Reports
https://www.readbyqxmd.com/read/29858936/bowel-obstruction-complicated-by-ischemia-analysis-of-ct-findings
#5
Veronica L Cox, Ali M Tahvildari, Benjamin Johnson, Wei Wei, R Brooke Jeffrey
PURPOSE: To analyze CT signs of bowel ischemia in patients with surgical bowel obstruction, and thereby improve CT diagnosis in this common clinical scenario. Surgical and histopathological findings were used as the reference standard. METHODS: We retrospectively analyzed CT findings in patients brought to surgery for bowel obstruction over 13 years. Etiology of obstruction (adhesion, hernia, etc.) was recorded. Specific CT features of acute mesenteric ischemia (AMI) were analyzed, including bowel wall thickening, mucosal hypoenhancement, and others...
June 1, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29857826/the-effects-of-s-nitrosoglutathione-on-intestinal-ischemia-reperfusion-injury-and-acute-lung-injury-in-rats-roles-of-oxidative-stress-and-nf-%C3%AE%C2%BAb
#6
Inci Turan, Hale Sayan Ozacmak, V Haktan Ozacmak, Figen Barut, I Diler Ozacmak
BACKGROUND: Intestinal ischemia and reperfusion (I/R) induces oxidative stress, inflammatory response, and acute lung injury. S-nitrosoglutathione (GSNO), a nitric oxide donor, has been documented to have protective effects on experimental ischemia models. AIM: The aim of this study was to examine the effect of GSNO on I/R-induced intestine and lung damage and detect the potential mechanisms emphasizing the protective role of GSNO. METHODS: Intestinal I/R was induced by occluding the superior mesenteric artery for 30 min followed by reperfusion for 180 min...
June 2018: Tissue & Cell
https://www.readbyqxmd.com/read/29850337/a-case-of-septicemia-due-to-nonocclusive-mesenteric-ischemia-occurring-in-induction-chemotherapy
#7
Hideki Tanaka, Kiyoaki Tsukahara, Isaku Okamoto, Rio Kojima, Kazuhiro Hirasawa, Hiroki Sato
In nonocclusive mesenteric ischemia (NOMI), mesenteric ischemia and intestinal necrosis occur despite the absence of organic blockage in mesenteric blood vessels. As abdominal pain is often absent and few characteristic findings are seen in blood biochemistry, imaging diagnosis or other examinations, discovery is often delayed. With a mortality rate of 56-79%, NOMI is a very serious disease. However, few reports have described this pathology in association with chemotherapy regimens such as those used for malignant head and neck tumors...
2018: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/29808329/-operative-revascularization-of-visceral-arteries-in-chronic-mesenteric-ischemia
#8
REVIEW
H Gutsche, U Will, S Venth, T Lesser
Chronic mesenteric ischemia (CMI) is mostly the result of atherosclerotic occlusive processes of unpaired mesenteric arteries. Operative procedures are preferred in cases of occlusion of a long vessel segments and/or highly calcified stenoses near the ostium. Frequently, bypasses are constucted from the aorta to visceral arteries and autologous veins should be preferred. Due to atherosclerotic alterations aortic bypass anastomoses are difficult and prone to complications. Based on case descriptions a surgical technique is presented that simplifies the aortovisceral artery bypass procedure...
May 28, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29808123/mesenteric-ischemia-and-myocardial-infarction-associated-with-atrial-fibrillation
#9
Liting Cheng, Yongquan Wu
Atrial fibrillation is a common disease correlated with embolism incidents. However, there is lack of report on atrial fibrillation causing myocardial infarction and mesenteric ischemia at the same time. Our patient is a 69-year-old woman who had undergone thoracic surgery a month before presented to our hospital with newly discovered atrial fibrillation, abdominal pain, and ST-elevated myocardial infarction. This is a rare case that atrial fibrillation took place one month after surgery and caused embolism incidents in both coronary artery and mesenteric artery...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29777839/-mesenteric-steal-physiology-as-a-cause-of-claudication-and-chronic-mesenteric-ischemia
#10
Aleem K Mirza, J Michael Bacharach
Aortoiliac occlusive disease (AOID) results in varying degrees of pelvic and lower extremity arterial insufficiency. Treatment approach has evolved and endovascular therapies are being successfully reported for high-grade lesion. However, Trans Atlantic Inter-Society Consensus (TASC) D often necessitates open revascularization. Disease limited to the infrarenal segment does not typically affect intestinal perfusion in the absence of visceral aortic or mesenteric vessel involvement. Chronic mesenteric ischemia most commonly occurs due to atherosclerotic disease of two or three of the mesenteric vessels...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29776790/-modern-treatment-of-mesenteric-ischemia
#11
Alexandre Nuzzo, Audrey Huguet, Olivier Corcos
Acute mesenteric ischemia is a highly morbid affliction which requires urgent care. Acute mesenteric ischemia consists in an ischemia injury of the small bowel, secondary to vascular insufficiency, either occlusive (thrombosis, embolism, arterial, venous) or non-occlusive (low flow or vasospasm). Given that the superior mesenteric artery supplies the small bowel as well as the right part of the colon, any ischemic process involving the right colon should be considered an acute mesenteric ischemia until proven otherwise...
May 15, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29771572/inhibition-of-ubiquitin-activating-enzyme-protects-against-organ-injury-after-intestinal-ischemia-reperfusion
#12
Shingo Matsuo, Andrew Chaung, Deanna Liou, Ping Wang, Weng-Lang Yang
Intestinal ischemia-reperfusion (I/R) occurs in various clinical settings, such as transplantation, acute mesenteric arterial occlusion, trauma and shock. I/R injury causes severe systemic inflammation, leading to multiple organ dysfunction associated with high mortality. The ubiquitin proteasome pathway has been indicated in the regulation of inflammation, particularly through NF-κB signaling pathway. PYR-41 is a small molecular compound that selectively inhibits ubiquitin-activating enzyme E1. A mouse model of intestinal I/R injury by clamping the superior mesenteric artery for 45 minutes was performed to evaluate the effect of PYR-41 treatment on organ injury and inflammation...
May 17, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29767265/knockdown-of-tnf%C3%A2-%C3%AE-alleviates-acute-lung-injury-in-rats-with-intestinal-ischemia-and-reperfusion-injury-by-upregulating-il%C3%A2-10-expression
#13
Zhen Yang, Xue-Rong Zhang, Qiong Zhao, Sheng-Lan Wang, Liu-Lin Xiong, Piao Zhang, Bing Yuan, Zi-Bing Zhang, Shu-Yuan Fan, Ting-Hua Wang, Yun-Hui Zhang
Intestinal ischemia and reperfusion (II/R) injury often triggers severe injury in remote organs, with the lungs being considered the main target. Excessive elevation of proinflammatory cytokines is a major contributor in the occurrence and development of II/R‑induced acute lung injury (ALI). Therefore, the present study aimed to investigate whether blocking tumor necrosis factor‑α (TNF‑α) expression could protect the lungs from injury following II/R, and to explore the possible underlying mechanism involving interleukin‑10 (IL‑10)...
May 14, 2018: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29760544/ischemia-reperfusion-injury-in-porcine-intestine-viability-assessment
#14
Runar J Strand-Amundsen, Henrik M Reims, Finn P Reinholt, Tom E Ruud, Runkuan Yang, Jan O Høgetveit, Tor I Tønnessen
AIM: To investigate viability assessment of segmental small bowel ischemia/reperfusion in a porcine model. METHODS: In 15 pigs, five or six 30-cm segments of jejunum were simultaneously made ischemic by clamping the mesenteric arteries and veins for 1 to 16 h. Reperfusion was initiated after different intervals of ischemia (1-8 h) and subsequently monitored for 5-15 h. The intestinal segments were regularly photographed and assessed visually and by palpation. Intraluminal lactate and glycerol concentrations were measured by microdialysis, and samples were collected for light microscopy and transmission electron microscopy...
May 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29758324/exertional-abdominal-pain-as-a-rare-presenting-manifestation-of-chronic-mesenteric-ischemia-from-a-single-mesenteric-vessel-stenosis
#15
Heepeel Chang, Neal C Hadro, Marc A Norris, Marvin E Morris
We present an atypical manifestation of chronic mesenteric ischemia in a patient with progressively worsening exertional abdominal pain. Imaging modalities revealed significant isolated stenosis of superior mesenteric artery. Successful angioplasty and stenting of superior mesenteric artery relieved patient's symptoms, thereby confirming the diagnosis of CMI. Exertional abdominal pain may be a unique manifestation of this disease, but when it presents, clinicians should have acute clinical awareness of this diagnosis...
May 11, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29757725/acute-mesenteric-ischemia-multidetector-ct-findings-and-endovascular-management
#16
Shuzo Kanasaki, Akira Furukawa, Kanako Fumoto, Yasuyo Hamanaka, Shinichi Ota, Tomohiro Hirose, Akitoshi Inoue, Takako Shirakawa, Linh Dai Hung Nguyen, Syerikjan Tulyeubai
Acute mesenteric ischemia is a rare life-threatening condition that accounts for approximately one in 1000 hospital admissions. The mortality rate is 50%-69% owing to the absence of specific symptoms and laboratory data, which makes early detection of this condition difficult. If the use of contrast material is possible, biphasic contrast material-enhanced multidetector computed tomography (CT) is the first-line imaging test for early diagnosis of the disease and for differentiation from other causes of acute abdomen...
May 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29752997/indications-and-perioperative-outcomes-for-pancreatectomy-with-arterial-resection
#17
May C Tee, Adam C Krajewski, Ryan T Groeschl, Michael B Farnell, David M Nagorney, Michael L Kendrick, Sean P Cleary, Rory L Smoot, Kristopher P Croome, Mark J Truty
BACKGROUND: Pancreatectomy with AR is infrequently performed. As indications evolve, we evaluated indications, outcomes and predictors of mortality, morbidity, and survival after AR. STUDY DESIGN: Single-institution review of elective pancreatectomies with AR (7/1990-7/2017). Univariate/multivariate analyses performed for predictors of outcomes and survival. RESULTS: Total of 111 patients underwent pancreatectomy with AR including any hepatic (54%), any celiac (44%), any superior mesenteric (14%), or multiple ARs (14%) with revascularization in 55%...
May 9, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29743484/released-mitochondrial-dna-following-intestinal-ischemia-reperfusion-induces-the-inflammatory-response-and-gut-barrier-dysfunction
#18
Qiongyuan Hu, Huajian Ren, Jianan Ren, Qinjie Liu, Jie Wu, Xiuwen Wu, Guanwei Li, Gefei Wang, Guosheng Gu, Kun Guo, Zhiwu Hong, Song Liu, Jieshou Li
Ischemia-reperfusion (I/R) injury is a challenging clinical problem, especially injuries involving the gastrointestinal tract. Mitochondrial DNA (mtDNA) is released upon cell death and stress, and can induce the inflammatory response. We aimed to investigate the role of mtDNA in the pathogenesis of intestinal I/R. Intestinal I/R model was established with clamping of the superior mesenteric artery, and IEC-6 cells were incubated under hypoxia/reoxygenation (H/R) conditions to simulate I/R injury. Using in vitro models, H/R up-regulated oxidative stress, disrupted mitochondrial activity and the mitochondrial membrane potential, induced apoptosis and elevated the mtDNA levels in the supernatant of intestinal epithelial cells, and the co-culture of mtDNA with human primary dendritic cells significantly elevated TLR9-MyD88 expression and enhanced the production of inflammatory cytokines and chemokines...
May 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29716480/spontaneous-isolated-inferior-mesenteric-artery-dissection-with-chronic-mesenteric-ischemia-case-report-and-endovascular-management
#19
Suresh Giragani, Ankit Balani, Viswanath Reddy, Keerthi Talari Bommakanti, Surendar Alwala, Anjani Kumar
We report the clinical details, imaging findings, and management for a 39-year-old female presenting with recurrent episodes of pain in abdomen due to systemic lupus erythematous vasculitis associated with spontaneous isolated inferior mesenteric dissection. Spontaneous mesenteric artery dissection is an uncommon cause of mesenteric ischemia. Symptomatic spontaneous isolated inferior mesenteric artery (IMA) dissection is a rare condition, and its association with systemic lupus erythematosus is not previously described in the English literature...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29701357/frozen-elephant-trunk-with-e-vita-open-hybrid-prosthesis-for-surgical-correction-of-multisegmental-thoracic-aortic-pathology-review-of-results
#20
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
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