scholarly journals Late Vascular Intervention for Acute Mesenteric Ischemia Is Associated with Early Mortality and Extensive Bowel Resection

2021 ◽  
Vol 73 (3) ◽  
pp. 48-49
Author(s):  
Lillian M. Tran ◽  
Elizabeth Andraska ◽  
Rafael Ramos-Jiminez ◽  
Andrew-Paul Deeb ◽  
Natalie Sridharan ◽  
...  
Keyword(s):  
Mesenteric Ischemia ◽  
Bowel Resection ◽  
Acute Mesenteric Ischemia ◽  
Early Mortality ◽  
Vascular Intervention

scholarly journals The Utility of Biomarkers in Diagnosing and Predicting Outcomes in Acute Mesenteric Ischemia

2021 ◽  
Vol 17 (2) ◽  
pp. 119-126
Author(s):  
Cătălin Alexandru Pirvu ◽  
Felix Bratosin ◽  
Cristian Nica ◽  
Dan Cârțu ◽  
Patrascu Ștefan ◽  
...  
Keyword(s):  
Mesenteric Ischemia ◽  
Complete Blood Count ◽  
Significant Risk ◽  
Acute Mesenteric Ischemia ◽  
Cross Sectional ◽  
Vascular Intervention ◽  
Predicted Probability ◽  
General Surgeons ◽  
Cross Sectional Design ◽  
Acute Condition

Background: Acute intestinal ischemia stands as the most lethal acute condition encountered by general surgeons and one of the deadliest pathologies in medicine triggered by thromboembolic events. The patients’ survival decreases dramatically to a lower than 30% rate when diagnosed after 24 hours, thus early diagnosis with proper surgical or vascular intervention is mandatory. This study aims to determine the utility of biomarkers and routine blood tests in assessing the severity and mortality risk for patients with acute mesenteric ischemia. Methods: The study was developed on a prospective cross-sectional design over a period of five years, finding a total of 147 patients who underwent emergency surgery after a high suspicion of acute mesenteric ischemia. The available biomarkers used in our Clinic comprised a complete blood count, total bilirubin, CK, CK-MB, LDH, AST, ALT, amylase, and cholinesterase. Results: The leukocyte count (OR=1.105), hemoglobin (OR=3.912), LDH (OR=1.144), NLR (OR=1.154), and LLR (OR=1.286) were all independent and significant risk factors for AMI diagnosis. These covariates proved a good and reliable tool for diagnosing AMI with a 75.3% predicted probability. Conclusion: The prediction tool proved reliable, although it should only be considered in the clinical context where the surgeon suspects a case of acute mesenteric ischemia. The proposed model should be further investigated and validated in larger studies.

AN EMERGENT MANAGEMENT OF ACUTE SUPERIOR MESENTERIC ARTERY EMBOLISM WITH ILEAL GANGRENE

2021 ◽  
pp. 3-4
Author(s):  
Nishant Agarwal ◽  
Abhishek Kaushal ◽  
Shrey Aren ◽  
Srikanth Muraleedhar ◽  
Sudhir Kumar Panigrahi
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Intestinal Ischemia ◽  
Hospital Admissions ◽  
Bowel Resection ◽  
Acute Mesenteric Ischemia ◽  
Artery Embolism ◽  
Visceral Arteries ◽  
Bowel Gangrene

Acute mesenteric ischemia (AMI) occuring due to sudden, partial or complete interruption of blood ow in main visceral arteries of the abdomen eventually resulting in intestinal ischemia and/or bowel gangrene is a surgical emergency. It represents 0.1% of hospital admissions and 2% of the revascularization operations for atheromatous lesions. 50% of AMI is caused by embolic phenomenon, 25% by thrombotic episode and rest 25% by both. The most common vessel involved in AMI is superior mesenteric artery. Acute mesenteric embolic ischemia (AMEI) arises typically from a cardiac emboli in patients with atrial brillation or following MI. Patients usually presents with central abdominal pain, out of proportion to the physical ndings initially, later becoming diffuse associated with bloody diarrhoea during the episode. An early diagnosis, an aggressive resuscitation, intravascular or surgical restoration of blood ow and subsequent bowel resection based on bowel viability helps reduce morbidity and mortality.

scholarly journals Still time to perform intestinal revascularization in patients with acute mesenteric ischemia with peritonitis: An analysis of bowel viability in resections

2020 ◽  
Vol 8 ◽  
pp. 205031212092322
Author(s):  
Kentaro Hayashi ◽  
Ken Hayashi ◽  
Makoto Narita ◽  
Akira Tsunoda ◽  
Hiroshi Kusanagi
Keyword(s):  
Medical Records ◽  
Mesenteric Ischemia ◽  
Primary Outcome ◽  
Bowel Resection ◽  
Medical Center ◽  
Acute Mesenteric Ischemia ◽  
Pathological Evaluation ◽  
Reversible Ischemia ◽  
Massive Bowel Resection ◽  
Resected Bowel

Objective: Acute mesenteric ischemia is often fatal, and many survivors develop short bowel syndrome. To avoid massive bowel resection, revascularization is recommended for acute mesenteric ischemia patients. However, whether acute mesenteric ischemia patients with clinical peritonitis can be revascularized remains uncertain. Therefore, this study aimed to evaluate the histopathological potential reversibility of resected bowel in acute mesenteric ischemia patients with peritonitis. Methods: We retrospectively reviewed the medical records of acute mesenteric ischemia patients treated at the Kameda Medical Center between January 2001 and March 2015. Pathological evaluation regarding bowel resection was performed. Patients with and without peritonitis were compared. The primary outcome was the proportion of patients with reversible or irreversible ischemia. Patients with reversible and irreversible ischemia were characterized. Results: Of 41 patients, 17 underwent laparotomy, 6 endovascular surgery, and 18 palliative care. Among 23 patients receiving curative treatment, 7 had peritonitis and 13 did not. Seven patients of each group received bowel resection, but 85.7% of those with peritonitis had reversible ischemia. We categorized patients with ischemia into reversible and irreversible groups. The median time between symptom onset and diagnosis in the reversible group was >27 h. Systemic inflammatory response syndrome was found in 72.2% and 66.7% of the reversible and irreversible groups, respectively. Conclusion: Acute mesenteric ischemia patients with clinical peritoneal signs may have potentially reversible ischemia. As a result, revascularization should be considered, even in the case of peritonitis.

Mortality of acute mesenteric ischemia remains unchanged despite significant increase in utilization of endovascular techniques

Vascular ◽  
2015 ◽  
Vol 24 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Mohammad H Eslami ◽  
Denis Rybin ◽  
Gheorghe Doros ◽  
James T McPhee ◽  
Alik Farber
Keyword(s):  
Mortality Rate ◽  
Confidence Interval ◽  
Hospital Mortality ◽  
Odds Ratio ◽  
Mesenteric Ischemia ◽  
Bowel Resection ◽  
Acute Mesenteric Ischemia ◽  
Fold Increase ◽  
Endovascular Techniques ◽  
Contemporary Study

Introduction In this study, we evaluated if increase in utilization of endovascular surgery has affected in-hospital mortality rates among patients with acute mesenteric ischemia. Methods The National Inpatient Sample (2003–2011) was queried for acute mesenteric ischemia using ICD-9 code for acute mesenteric ischemia (557.1). This cohort was divided into patients treated with open vascular surgery (open vascular group) and by endovascular therapies (endovascular group) based on the ICD-9CM procedure codes. Multivariable logistic regression was used to determine temporal trend for mortality while adjusting for confounding variables. Results There was 1.45-fold increase in utilization of endovascular techniques in this study. In-hospital mortality rate, total median charges and length of stay were significantly lower among the endovascular group than the open vascular group despite having significantly higher Elixhauser comorbidities index (3 ± 0.1 vs. 2.7 ± 0.1, p = .003). Over the course of the study period, there was no change in the overall mortality rate despite higher endovascular utilization. Factors associated with increased mortality included age, open surgical repair (Odds ratio: 1.45, 95% Confidence Interval: 1.10–1.91, p = .016) and bowel resection Odds ratio: 2.88, 95% Confidence Interval: 2.01–4.12). Conclusion The mortality rate for acute mesenteric ischemia remains unchanged throughout this contemporary study. Open surgical intervention, bowel resection and age were associated with increased mortality. Endovascular group patients had better survival despite higher morbidity indices.

Open Procedures for Mesenteric Ischemia

2017 ◽  
Author(s):  
Ravi V Dhanisetty ◽  
Gregory L. Moneta ◽  
Rachel C Danczyk
Keyword(s):  
Blood Flow ◽  
Key Words ◽  
Mesenteric Ischemia ◽  
Bowel Resection ◽  
Acute Mesenteric Ischemia ◽  
Primary Patency ◽  
Chronic Mesenteric Ischemia ◽  
Hybrid Procedures ◽  
Viable Solution ◽  
Prompt Diagnosis

Mesenteric ischemia is a relatively rare disease that requires prompt diagnosis and treatment to preserve bowel and prevent mortality. Despite endovascular advances, open revascularization remains essential to reestablish blood flow in patients with either acute or chronic mesenteric ischemia. Open revascularization continues to provide excellent primary patency and durable relief of symptoms with acceptable morbidity and mortality. Acute mesenteric ischemia warrants prompt evaluation of the bowel for signs of infarction, and determining the etiology of the ischemia is critical to planning revascularization. Hybrid procedures provide a viable solution in those patients who are moribund and require revascularization and bowel resection. Key words: duplex graft surveillance, mesenteric bypass, mesenteric ischemia, open revascularization, retrograde open mesenteric stenting

scholarly journals Bowel Resection With Open and Endovascular Repair for Acute Mesenteric Ischemia

2012 ◽  
Vol 56 (3) ◽  
pp. 885
Author(s):  
Robert J. Beaulieu ◽  
Eric Schneider ◽  
Chris Abularrage ◽  
James H. Black
Keyword(s):  
Endovascular Repair ◽  
Mesenteric Ischemia ◽  
Bowel Resection ◽  
Acute Mesenteric Ischemia

Morbidity and mortality after bowel resection for acute mesenteric ischemia

Surgery ◽  
2011 ◽  
Vol 150 (4) ◽  
pp. 779-787 ◽  
Author(s):  
Prateek K. Gupta ◽  
Bala Natarajan ◽  
Himani Gupta ◽  
Xiang Fang ◽  
Robert J. Fitzgibbons
Keyword(s):  
Mesenteric Ischemia ◽  
Bowel Resection ◽  
Acute Mesenteric Ischemia ◽  
Morbidity And Mortality

Acute mesenteric ischemia with necrosis of entire small intestine

2019 ◽  
Vol 98 (4) ◽  
pp. 174-177
Keyword(s):  
Small Intestine ◽  
Mesenteric Ischemia ◽  
Severe Disease ◽  
Acute Mesenteric Ischemia ◽  
Diagnostic Methods ◽  
Entire Small Intestine ◽  
Common Etiology

The case study describes a case of a patient with acute mesenteric ischemia with necrosis of entire small intestine. In following text there is an overview of the incidence of acute mesenteric ischemia, its most common etiology, diagnostic methods and treatment of this severe disease.

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