Predictors Of Transmural Intestinal Necrosis In Patients Presenting With Acute Mesenteric Ischemia On Computed Tomography.

2020 ◽  
Vol 14 (3) ◽  
pp. S72-S73
Author(s):  
I. Atre ◽  
K. Eurboonyanun ◽  
A. O'Shea ◽  
R. Lahoud ◽  
A. Shih ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Intestinal Necrosis

The role of computed tomography in the diagnostic pathway of acute mesenteric ischemia: a nested case-control study

2020 ◽  
Vol 61 (11) ◽  
pp. 1444-1451
Author(s):  
Henning Mothes ◽  
Vetlana Mueller-Mau ◽  
Lukas Lehmkuhl ◽  
Thomas Lehmann ◽  
Utz Settmacher ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Surgery ◽  
Ct Scan ◽  
Contrast Medium ◽  
Mesenteric Ischemia ◽  
Case Control Study ◽  
Acute Mesenteric Ischemia ◽  
Case Control ◽  
Intestinal Pneumatosis ◽  
Control Study

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.

scholarly journals Predictive factors of intestinal necrosis in acute mesenteric ischemia

Open Medicine ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 883-889 ◽  
Author(s):  
Alfonso Canfora ◽  
Antonio Ferronetti ◽  
Gianpaolo Marte ◽  
Vittorio Di Maio ◽  
Claudio Mauriello ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Organ Failure ◽  
Predictive Factors ◽  
Mesenteric Ischemia ◽  
Disease Risk ◽  
Acute Mesenteric Ischemia ◽  
Serum Lactate ◽  
Intestinal Necrosis ◽  
Ct Findings ◽  
Lactate Levels

AbstractObjectivesAcute mesenteric ischemia (AMI) is a gastrointestinal and vascular emergency in which the detection of patients requiring intestinal resection is mandatory.MethodsRegistered data of 55 consecutive patients admitted to our center between January 2010 and December 2016 that underwent an explorative laparotomy for a suspected diagnosis of irreversible transmural intestinal necrosis (ITIN) were analyzed. Demographic, clinical, laboratory and CT findings were statistically analyzed in order to search predictive factors of ITIN and their correlation to its clinical spectre.ResultsTobacco use was the most statistically significant (p<0.01) cardiovascular disease risk factor involved in ITIN. Among lab tests, Serum lactate levels ˃ 2mmol/L resulted in a statistically significant association with ITIN (p=0.0001). Organ failure (defined as Marshall score> 2) and the three main CT findings (decreased bowel wall enhancement, bowel loop dilation and demonstrated vessel occlusion) were strongly associated with ITIN (p values: 0.001, 0.007, 0.0013, 0.0005). Only serum lactate levels>2 mmol/L resulted as statistically significant as predictive factors of ITIN in multivariate analysis using logistic regression (OR 49.66 and p-value 0.0021).ConclusionOur univariate and multivariate analysis identified multiple factors (Serum lactate levels ˃ 2mmol/L, Organ failure, CT signs) that could suggest patients that require a surgical approach for ITIN.

Value of multislice computed tomography in the diagnosis of acute mesenteric ischemia

2011 ◽  
Vol 80 (2) ◽  
pp. 297-302 ◽  
Author(s):  
Ali Yikilmaz ◽  
Okkes Ibrahim Karahan ◽  
Serkan Senol ◽  
Ibrahim Sacit Tuna ◽  
Hizir Yakup Akyildiz
Keyword(s):  
Computed Tomography ◽  
Mesenteric Ischemia ◽  
Multislice Computed Tomography ◽  
Acute Mesenteric Ischemia

scholarly journals Retrospective study of mesenteric ischemia

2020 ◽  
Vol 7 (8) ◽  
pp. 2544
Author(s):  
Mallikarjuna Reddy Mandapati ◽  
Sanjeev Kumar Jukuri ◽  
Nageswara Rao Nasika ◽  
Haleema Neshat
Keyword(s):  
Risk Factors ◽  
Small Intestine ◽  
Retrospective Study ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Delay Group ◽  
Late Mortality ◽  
Intestinal Necrosis ◽  
Life Threatening ◽  
Overall Mortality

Background: 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.Methods: A monocentric retrospective study was conducted between 01 August 2013 and 31 December 2019; 24 AMI patients underwent surgery (17 men and 7 women). Retrospectively, the risk factors, management until diagnosis and mortality were evaluated.Results: Patients present with an acute pain of the abdomen. Diagnosis was provided by CT with contrast medium. The 30-day mortality was 45.8%, the late mortality was 25% and the overall mortality was 70.8%. For the <12 hours delay group, the mortality was 33.3%, and the mortality in the group with 12-24 hours delay was 80% and was 87.5% in the >24 hours after admission group.Conclusions: If untreated, this process will eventuate in life threatening intestinal necrosis. The incidence is low, estimated at 0.09-0.21% of all acute surgical admissions.

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