Chronic mesenteric ischaemia: the importance of the individual mesenteric artery

2021 ◽  
Author(s):  
Christian Høyer ◽  
Mette Høgh Christensen ◽  
Jes Sandermann ◽  
Robert Leusink ◽  
Jan Abrahamsen
Keyword(s):  
Mesenteric Artery ◽  
Mesenteric Ischaemia ◽  
Chronic Mesenteric Ischaemia ◽  
The Individual

scholarly journals Chronic mesenteric ischaemia masked by candida esophagitis in a renal transplant patient

2019 ◽  
Vol 12 (12) ◽  
pp. e232938 ◽  
Author(s):  
Seth Scheetz ◽  
Deepali Pandey ◽  
Todd E Pesavento ◽  
Priyamvada Singh
Keyword(s):  
Mesenteric Artery ◽  
Renal Transplant Patient ◽  
Transplant Patient ◽  
Surgical Intervention ◽  
Gastrointestinal Disease ◽  
Severe Disease ◽  
Mesenteric Ischaemia ◽  
Candida Esophagitis ◽  
Immunosuppressed Patients ◽  
Chronic Mesenteric Ischaemia

Chronic mesenteric ischaemia is a severe disease that is often missed due to its non-specific presentation. Immunosuppressed patients are at risk for infectious gastrointestinal disease, which may further obscure the diagnosis of chronic mesenteric ischaemia. In this case, a patient’s symptoms and diagnostic workup were consistent with candida esophagitis. Worsening leukocytosis despite treatment, however, prompted re-evaluation ultimately revealing a superior mesenteric artery thrombus causing mesenteric ischaemia. The patient required urgent surgical intervention for the management of his disease.

scholarly journals TP5.2.11 Intervention for mesenteric arterial insufficiency in octogenarians

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Sachin Shenoy ◽  
Kevin Daly ◽  
Wesley Stuart ◽  
Alan Meldrum ◽  
Keith Hussey
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Artery Occlusion ◽  
Mesenteric Ischaemia ◽  
Older Patient ◽  
Common Procedure ◽  
Endovascular Approach ◽  
Arterial Insufficiency ◽  
Chronic Mesenteric Ischaemia

Abstract Introduction Mesenteric ischaemia is associated with significant morbidity and mortality. The poor prognosis associated with mesenteric ischaemia may prejudice decision-making, particularly for an older patient group. We have explored outcomes following intervention for mesenteric ischaemia in patients aged over 80-years old. Methods This was a retrospective analysis of a database of intervention for mesenteric ischaemia from 2010 to 2020 from a regional vascular unit covering two Health Boards in Scotland. Patients aged 80-years and over were identified and patterns of intervention and outcome described. Results There were 23 procedures performed – there were 17 patients aged 80-years or over. There were 8 patients with acute presentations, 6 had isolated superior mesenteric artery occlusion and thromboembolectomy was the most common procedure (n = 4). Laparotomy was performed in all cases and bowel resection required in 3. At 30-days 4 patients had died, but patients who survived the index admission were still alive at 1-year and symptom free. Elective was performed on 9 patients. An endovascular approach was favoured (n = 7) with the superior mesenteric artery the preferred target. At 30-days 2 had died, but at 1-year there had only been 1 further death. Three patients experienced recurrent symptoms. The remaining patients were symptom free. Conclusion It is appropriate to consider mesenteric intervention for older patients with both acute and chronic mesenteric ischaemia. Meaningful survival can be achieved with good relief of symptoms and return to meaningful quality of life.

Noninvasive evaluation of the celiac trunk and superior mesenteric artery with multislice CT in patients with chronic mesenteric ischaemia

2008 ◽  
Vol 113 (8) ◽  
pp. 1135-1142 ◽  
Author(s):  
F. Cademartiri ◽  
A. Palumbo ◽  
E. Maffei ◽  
C. Martini ◽  
R. Malagò ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Multislice Ct ◽  
Celiac Trunk ◽  
Noninvasive Evaluation ◽  
Mesenteric Ischaemia ◽  
Chronic Mesenteric Ischaemia

scholarly journals Retrograde open superior mesenteric artery stenting: a novel approach to managing occluded ilio-superior mesenteric artery grafts

2019 ◽  
Vol 12 (12) ◽  
pp. e233500
Author(s):  
Michael G Fadel ◽  
Brian Andrews
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Open Surgery ◽  
Early Postoperative Period ◽  
Hybrid Technique ◽  
Mesenteric Ischaemia ◽  
Endovascular Stenting ◽  
Novel Approach ◽  
Endovascular Approach ◽  
Chronic Mesenteric Ischaemia

Acute mesenteric ischaemia (AMI) can be treated either by open bypass grafting or occasionally by antegrade endovascular stenting. We present a patient with symptoms of AMI, in the early postoperative period, following thrombosis of an iliac to superior mesenteric bypass to treat chronic mesenteric ischaemia. A hybrid technique combining open surgery with a retrograde endovascular approach was performed. This allowed for direct visualisation of the bowel and immediate revascularisation of the mesenteric circulation.

scholarly journals Successful Treatment of Acute on Chronic Mesenteric Ischaemia by Common Iliac to Inferior Mesenteric Artery Bypass

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
D. N. Coakley ◽  
F. M. Shaikh ◽  
E. G. Kavanagh
Keyword(s):  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Artery Bypass ◽  
Celiac Artery ◽  
Mesenteric Arteries ◽  
Surgical Patient ◽  
Mesenteric Ischaemia ◽  
Atherosclerotic Stenosis ◽  
Vein Bypass ◽  
Chronic Mesenteric Ischaemia

Chronic mesenteric ischaemia is a rare and potentially fatal condition most commonly due to atherosclerotic stenosis or occlusion of two or more mesenteric arteries. Multivessel revascularisation of both primary mesenteric vessels, the celiac artery and superior mesenteric artery (SMA), is the current mainstay of treatment; however, in a certain cohort of patients, revascularisation one or both vessels may not be possible. Arteries may be technically unreconstructable or the patient may be surgically unfit for the prolonged aortic cross clamping times required. Here we present a case involving a 72-year-old woman with acute on chronic mesenteric ischaemia. She was a high risk surgical patient with severe unreconstructable stenotic disease of the SMA and celiac arteries. She was successfully treated with single vessel revascularisation of the inferior mesenteric artery (IMA) via a common iliac to IMA reversed vein bypass. At two-year follow-up, the graft remains patent and the patient continues to be symptom-free and is maintaining her weight.

scholarly journals Early risk stratification of patients with suspected chronic mesenteric ischaemia using a symptom and mesenteric artery calcium score based score chart

2021 ◽  
Author(s):  
Luke G. Terlouw ◽  
Desirée van Noord ◽  
Theo van Walsum ◽  
Louisa J. D. van Dijk ◽  
Adriaan Moelker ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Mesenteric Artery ◽  
Calcium Score ◽  
Mesenteric Ischaemia ◽  
Early Risk ◽  
Chronic Mesenteric Ischaemia

Chronic mesenteric ischaemia presenting as possible large bowl malignancy: an easily overlooked differential diagnosis

2021 ◽  
Vol 14 (3) ◽  
pp. e240202
Author(s):  
Benjamin McDonald
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Weight Loss ◽  
Differential Diagnosis ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Mesenteric Ischaemia ◽  
Abdominal Symptoms ◽  
Chronic Mesenteric Ischaemia ◽  
Descending Colon

An 80-year-old woman presented to a regional emergency department with postprandial pain, weight loss and diarrhoea for 2 months and a Computed Tomography (CT) report suggestive of descending colon malignancy. Subsequent investigations revealed the patient to have chronic mesenteric ischaemia (CMI) with associated bowel changes. She developed an acute-on-chronic ischaemia that required emergency transfer, damage control surgery and revascularisation. While the patient survived, this case highlights the importance of considering CMI in elderly patients with vague abdominal symptoms and early intervention to avoid potentially catastrophic outcomes.

Chronic mesenteric ischaemia: diagnostic challenges and treatment options

1995 ◽  
Vol 237 (3) ◽  
pp. 293-299 ◽  
Author(s):  
K. HOOGENBERG ◽  
L. H. ESSEN ◽  
J. J. A. M. DUNGEN ◽  
A. J. LIMBURG ◽  
W. J. BOEVE ◽  
...  
Keyword(s):  
Treatment Options ◽  
Mesenteric Ischaemia ◽  
Chronic Mesenteric Ischaemia
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