The role of bed-side laparoscopy in the management of acute mesenteric ischemia of recent onset in post-cardiac surgery patients admitted to ICU

Background Computed tomography (CT) can be used as the primary screening modality for the evaluation of patients suspected of having acute mesenteric ischemia known to show high sensitivity and specificity rates. Purpose To prove the value of CT in patients with pathological abdominal findings following cardiac surgery. Material and Methods In a retrospective case-control study, 12 different CT scan parameters of patients with or without mesenteric ischemia following cardiac surgery were compared using univariate and logistic regression analyses. Results Of 14,176 patients, 133 (0.9%) received an abdominal CT scan during postoperative care due to pathological abdominal findings. Sixty-eight patients were diagnosed with acute mesenteric ischemia. In-hospital mortality was 73.5% for this group. CT parameters with the highest specificity for indicating colonic ischemia were intestinal (99%) or porto-venous (96%) pneumatosis, abnormal contrast medium enhancement (89%), and occlusion of the proximal inferior mesenteric artery (81%). All of those parameters showed low sensitivity levels in the range of 15%–23%. A statistically significant association between acute mesenteric ischemia and CT appearance was obtained for contrast medium enhancement (odds ratio [OR] 12.2, 95% confidence interval [CI] 1.5–99.2) and intestinal pneumatosis (OR 21.0, 95% CI 2.7–165.2) only. Conclusion The typical CT criteria indicating mesenteric ischemia lose their accuracy in patients under critical clinical conditions. As CT remains the first-line diagnostic imaging modality for abnormal abdominal findings following cardiac surgery, negative signs should not prevent early laparotomy if clinical suspicion remains high.

Download Full-text

Role of Frailty and Comorbidity Status in Predicting Morbidity and Mortality in Patients with Acute Mesenteric Ischemia

Annals of Vascular Surgery ◽

10.1016/j.avsg.2020.03.037 ◽

2020 ◽

Vol 67 ◽

pp. 105-114 ◽

Cited By ~ 1

Author(s):

Fan-Feng Chen ◽

Xiao-Ning Ye ◽

Hao-Te Jiang ◽

Guan-Xia Zhu ◽

Shou-Liang Miao ◽

...

Keyword(s):

Mesenteric Ischemia ◽

Acute Mesenteric Ischemia ◽

Morbidity And Mortality ◽

Comorbidity Status

Download Full-text

Mediastinitis Post Cardiac Surgery and the Role of the Internal Mammary Artery: An Updated Risk Factors Analysis

Plastic & Reconstructive Surgery ◽

10.1097/01.prs.0000388806.38232.01 ◽

2010 ◽

Vol 126 ◽

pp. 84-85

Author(s):

Hani Sinno ◽

Gordan Samoukovic ◽

Rakesh K. Chaturvedi ◽

Stephane L.W. Sang ◽

Ahsan Alam ◽

...

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Internal Mammary Artery ◽

Factors Analysis ◽

Internal Mammary ◽

Post Cardiac Surgery

Download Full-text

1657 Mortality in Post-Cardiac Surgery in Children: The role of Multiple Organ Dysfunction

Archives of Disease in Childhood ◽

10.1136/archdischild-2012-302724.1657 ◽

2012 ◽

Vol 97 (Suppl 2) ◽

pp. A469-A469

Author(s):

T. d. Rocha ◽

A. Botta ◽

C. Ricachinevsky ◽

L. Mulle ◽

P. Carvalho

Keyword(s):

Cardiac Surgery ◽

Organ Dysfunction ◽

Multiple Organ ◽

Multiple Organ Dysfunction ◽

Post Cardiac Surgery

Download Full-text

ROLE OF LABORATORY METHODS IN INTEGRATED DIAGNOSTICS OF ACUTE MESENTERIAL ISCHEMIA

Medical Journal of the Russian Federation ◽

10.18821/0869-2106-2019-25-5-6-316-323 ◽

2019 ◽

Vol 25 (5-6) ◽

pp. 316-323

Author(s):

Dmitry V. Belov ◽

D. V Garbuzenko ◽

O. P Lukin ◽

S. S Anufrieva

Keyword(s):

Blood Flow ◽

Mesenteric Ischemia ◽

Acute Mesenteric Ischemia ◽

Intestinal Wall ◽

Mesenteric Blood Flow ◽

Scientific Publications ◽

Laboratory Methods ◽

Diagnostic Measures ◽

Pubmed Database

The aim of the review: to present literature data on the role of laboratory methods in the complex diagnosis of acute mesenteric ischemia. The main provisions. To search for scientific publications, we used the PubMed database, the RSCI, the Google Scholar search engine, as well as cited references. Articles relevant to the purpose of the review were selected for the period from 1999 to 2019 in the following terms: “acute mesenteric ischemia”, “pathogenesis”, “diagnosis”, “biomarkers”. Inclusion criteria were limited to acute arterial mesenteric ischemia. Acute mesenteric ischemia is an emergency condition caused by a sudden violation of the blood flow through the mesenteric vessels, which rapidly progresses to a heart attack of the intestinal wall and is accompanied by high mortality. Four main mechanisms of OMI are distinguished: embolism from the left parts of the heart or aorta, thrombosis of arteries or veins of the intestine, non-occlusive acute mesenteric ischemia (NOMI), due to vascular spasm. In this case, destructive disorders occur in the intestinal wall, starting from the mucous membrane to the serous, which leads to bacterial translocation and the development of a systemic inflammatory response syndrome. Early bowel revascularization is a key factor in reducing complications and mortality associated with it. However, in the initial stages of the disease has no specific signs, which complicate its diagnosis. The only way to detect mesenteric blood flow disorders is MSCT with angiography, and with non-occlusive lesions, mesenteric angiography, which in normal clinical practice is not always possible. Conclusion. It can be assumed that the use of laboratory methods will expand the range of diagnostic measures and will make it possible to conduct timely treatment aimed at restoring the mesenteric blood flow and improve the prognosis in patients with acute mesenteric ischemia.

Download Full-text

Role of Ischemia-Modified Albumin in Early Diagnosis of Acute Mesenteric Ischemia in Rats

Selcuk Tip Dergisi ◽

10.30733/std.2018.01014 ◽

2018 ◽

Vol 2 (34) ◽

pp. 55-59

Author(s):

Himmet Durgut ◽

Sukru Bulent Ozer ◽

Tevfik Kucukkartallar

Keyword(s):

Early Diagnosis ◽

Mesenteric Ischemia ◽

Acute Mesenteric Ischemia ◽

Ischemia Modified Albumin

Download Full-text

Kinetics of serum procalcitonin in patients with acute mesenteric ischemia and bowel infarction after cardiac surgery

The Journal of Cardiovascular Surgery ◽

10.23736/s0021-9509.21.11924-x ◽

2021 ◽

Author(s):

Raoul BORIONI ◽

Mariano GAROFALO ◽

Franco TURANI ◽

Luca P. WELTERT ◽

Carolina PACIOTTI ◽

...

Keyword(s):

Cardiac Surgery ◽

Mesenteric Ischemia ◽

Acute Mesenteric Ischemia ◽

Bowel Infarction ◽

Kinetics Of

Download Full-text

Role of Heparin Binding Protein (HBP) in the Diagnosis of Acute Mesenteric Ischemia

Turkish Journal of Trauma and Emergency Surgery ◽

10.5505/tjtes.2018.49139 ◽

2018 ◽

Cited By ~ 2

Author(s):

Sedat Koçak

Keyword(s):

Mesenteric Ischemia ◽

Binding Protein ◽

Acute Mesenteric Ischemia ◽

Heparin Binding ◽

Heparin Binding Protein

Download Full-text

Acute Mesenteric Ischemia after Cardiac Surgery: An Analysis of 52 Patients

The Scientific World JOURNAL ◽

10.1155/2013/631534 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 17

Author(s):

Cuneyt Eris ◽

Senol Yavuz ◽

Serhat Yalcinkaya ◽

Arif Gucu ◽

Faruk Toktas ◽

...

Keyword(s):

Cardiac Surgery ◽

Mesenteric Ischemia ◽

Acute Mesenteric Ischemia ◽

Left Ventricular ◽

Inotropic Support ◽

Left Ventricular Ejection ◽

Control Group ◽

Ventricular Ejection Fraction ◽

Gastrointestinal Complications ◽

Iabp Support

Objective. Acute mesenteric ischemia (AMI) is a rare but serious complication after cardiac surgery. The aim of this retrospective study was to evaluate the incidence, outcome, and perioperative risk factors of AMI in the patients undergoing elective cardiac surgery.Methods. From January 2005 to May 2013, all patients who underwent cardiac surgery were screened for participation, and patients with registered gastrointestinal complications were retrospectively reviewed. Univariate analyses were performed.Results. The study included 6013 patients, of which 52 (0.86%) patients suffered from AMI, 35 (67%) of whom died. The control group (150 patients) was randomly chosen from among cases undergoing cardiopulmonary bypass (CPB). Preoperative parameters including age (), renal insufficiency (), peripheral vascular disease (), preoperative inotropic support (), poor left ventricular ejection fraction (), cardiogenic shock (), and preoperative intra-aortic balloon pump (IABP) support () revealed significantly higher levels in the AMI group. Among intra- and postoperative parameters, CPB time (), dialysis (), inotropic support (), prolonged ventilator time (), and IABP support () appeared significantly higher in the AMI group than the control group.Conclusions. Prompt diagnosis and early treatment should be initiated as early as possible in any patient suspected of AMI, leading to dramatic reduction in the mortality rate.

Download Full-text