scholarly journals Acute Mesenteric Ischemia: A Challenge for the Acute Care Surgeon

2021 ◽  
pp. 145749692110075
Author(s):  
J. M. Kärkkäinen

Acute mesenteric ischemia is considered uncommon, but it appears to be more frequent cause of acute abdomen than appendicitis or ruptured abdominal aortic aneurysm in elderly patients. Surgical treatment without revascularization is associated with high overall mortality, up to 80%. The modern treatment of acute mesenteric ischemia requires collaboration of gastrointestinal surgeons, vascular surgeons, and interventional radiologists. Early revascularization may reduce the overall mortality associated with acute mesenteric ischemia by up to 50%. Clinical suspicion and contrast-enhanced computed tomography performed at early stage are keys to improve outcomes of acute mesenteric ischemia treatment. This review summarizes what the acute care surgeon needs to know about acute mesenteric ischemia with special emphasis on slowly progressing “acute on chronic” mesenteric ischemia.

2021 ◽  
Author(s):  
hong sun ◽  
min zhao

Abstract Primary angiosarcoma is extremely rare malignant tumor that has no typical symptoms and progress rapidly with poor prognosis. It is mesenchymal in origin and observed most frequently in the right atrium, cases in the pericardium is much more rare. Only few can detected in the early-stage allowing complete radical resection with a mean survival of 3 months to 1 year. There is few pericardial angiosarcoma reported among these years. The present study reports a case of a 44-year-old woman with primary pericardial angiosarcoma, who underwent a wide range of imaging methods, including transthoracic echocardiography, contrast-enhanced computed tomography (CT) and positron emission tomography-magnetic resonance imaging (PET-MRI). The patient recovered well after operation in two years and died due to the recrudescence and pulmonary metastases in April, 2020. We report the case for its rarity and revealing the early detection of primary pericardial angiosarcoma with imaging examinations is critical for prognosis. Finally a literature review is done.


1997 ◽  
Vol 4 (3) ◽  
pp. 312-315 ◽  
Author(s):  
Greg van Schie ◽  
Kishore Sieunarine ◽  
Mike Holt ◽  
Michael Lawrence-Brown ◽  
David Hartley ◽  
...  

Purpose: To report the successful endovascular occlusion of a persistent endoleak owing to collateral perfusion in a 1-year-old bifurcated aortic endograft. Methods and Results: An 81-year-old man underwent endovascular repair of a 5.5-cm abdominal aortic aneurysm (AAA) with a bifurcated stent-graft in 1995; collateral perfusion of the excluded aneurysm by retrograde filling of the patent inferior mesenteric artery (IMA) was noted postoperatively. At his 1-year follow-up, the mid-sac endoleak persisted on contrast-enhanced computed tomography. Using the superior mesenteric artery for access, the stump of the IMA was successfully embolized with glue. Conclusions: This case, which highlights the importance of documenting a patent IMA prior to AAA endografting, illustrates one option for the management of persistent collateral perfusion of endovascularly excluded aneurysms.


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