scholarly journals Clinical cases of surgical treatment of bowel infarction caused by acute mesenteric ischemia combined with colon cancer

2018 ◽  
Vol 99 (4) ◽  
pp. 708-711
Author(s):  
F Sh Akhmetzyanov ◽  
N A Valiev ◽  
V I Egorov ◽  
M V Rozengarten ◽  
D V Burba
Keyword(s):  
Colon Cancer ◽  
Surgical Treatment ◽  
Emergency Surgery ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Colon Resection ◽  
Cancer Center ◽  
Bowel Infarction ◽  
Surgical Interventions ◽  
Clinical Cases

The article contains description of such serious pathology in emergency surgery as bowel infarction caused by acute mesenteric ischemia in two patients with colorectal cancer admitted to Tatarstan regional clinical cancer center. Patients were admitted for emergency indications with the clinic of an acute abdomen. Both patients underwent an emergency surgery of laparotomy, enterectomy with colon resection and anastomosis. Both patients had satisfactory immediate postoperative results. One patient died 8 months later due to the progression of the underlying disease, the second one is alive to the present day with a satisfactory quality of life and the only complain of frequent loose bowel movements. Most patients with acute mesenteric ischemia are operated on with trial diagnostic laparotomy, and mortality rate for this pathology reaches 90% or more. The presented clinical cases familiarize physicians with an opportunity of successful surgical treatment of patients with acute mesenteric ischemia combined with colon cancer and demonstate expediency and need for surgical interventions with extensive colon resection.

scholarly journals FROM THE HISTORY OF ACUTE MESENTERIC OCCLUSION (THE EPOCH OF NEW TIME). Part I

2015 ◽  
pp. 37-41
Author(s):  
O. Sh. Oynotkinova ◽  
A. V. Esipov ◽  
M. D. Pacenko ◽  
D. A. Mironenko ◽  
A. V. Tyschuk
Keyword(s):  
Nineteenth Century ◽  
Emergency Surgery ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Modern Medicine ◽  
Bowel Infarction ◽  
Acute Infarction ◽  
History Of ◽  
Time Part ◽  
Historical Periods

Acute mesenteric occlusions and acute bowel infarction were described in the middle of the nineteenth century. In spite of the achievements of modern medicine acute mesenteric ischemia is still one of the most dangerous pathologies in emergency surgery. This survey covers the historical periods of research of certain aspects of acute infarction of mesenteric circulation, which shaped our modern perception of this disease.

scholarly journals ACUTE MESENTERIC ISCHEMIA (CLINICAL CASES)

2016 ◽  
Vol 1 (2) ◽  
pp. 64-67
Author(s):  
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Vladimir Sobotovich ◽  
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Aleksandr Kalinichenko ◽  
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...  
Keyword(s):  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Fatality Rate ◽  
Bowel Infarction ◽  
Surgical Interventions ◽  
Vascular Bed ◽  
Pathological Conditions ◽  
High Fatality Rate ◽  
Mesenteric Vessels

Acute mesenteric ischemia is one of the most severe pathological conditions in terms of its course and prognosis. In the case of bowel infarction it is accompanied by an extremely high fatality rate. At the present day, despite there are ways to determine the patency of the vascular bed of the intestine accurately, developed principles and methods for the treatment of surgical interventions in different variants of acute occlusion of mesenteric vessels, it is not always possible to save the lives of patients with this disease. However, knowledge of the clinical picture of the disease, the consistent implementation of objective methods of diagnosis, timely decision on the need for surgical treatment can restore blood flow in the basin of the superior mesenteric artery and provide recovery and rehabilitation of these patients.

Use of indocianine green fluorescence in acute mesenteric ischemia

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Jaime Bonnín-Pascual
Keyword(s):  
Indocyanine Green ◽  
Terminal Ileum ◽  
Mesenteric Ischemia ◽  
Intestinal Anastomosis ◽  
Acute Mesenteric Ischemia ◽  
Left Colon ◽  
Infrared Light ◽  
High Morbidity ◽  
Green Fluorescence ◽  
Clinical Cases

Introduction: Acute mesenteric ischemia has a high morbidity and mortality and constitutes an intraoperative challenge in the management of ischemic areas. In this context, we analyze the use of indocyanine green fluorescence to assess intestinal vascularization through 3 clinical cases. Case presentation: we present 3 clinical cases operated for acute mesenteric ischemia. Evaluation of intestinal viability is performed under infrared light after intravenous infusion of 25 mg of indocyanine green. Case 1 is a 42-year-old male with multiple antecedents of severe vascular disease, presenting with a massive acute mesenteric ischemia involving multiple intestinal segments. Fluorescence allows two adjusted bowel resections with double intestinal anastomosis. Case 2 is a 74-year-old woman with a history of non-anticoagulated atrial fibrillation who is decided to perform an urgent surgery when an esophageal, gastric and portal system pneumatosis is observed, as indirect signs of ischemia, in urgent CT. During the surgical act there is an ischemia of the terminal ileum and right colon without clear signs of involvement at the esophageal-gastric level. The assessment after administration of ICG discriminates the clear ischemic involvement from terminal ileum to ascending colon and patched in the transverse and left colon, without esophageal or gastric involvement. Case 3 is a 49-year-old woman with aortoiliac and visceral Takayasu disease and revascularization surgery of the celiac trunk. Given the increase in abdominal pain, a new CT scan demonstrates colonic pneumatosis. Urgent laparotomy shows necrosis at the level of the left colon and hypoperfusion of the cecum. The administration of ICG finds a lack of uptake of the entire colon. A subtotal colectomy with ileostomy and mucous fistula is performed. Introduction: Acute mesenteric ischemia has a high morbidity and mortality and constitutes an intraoperative challenge in the management of ischemic areas. In this context, we analyze the use of indocyanine green fluorescence to assess intestinal vascularization through 3 clinical cases. Case presentation: we present 3 clinical cases operated for acute mesenteric ischemia. Evaluation of intestinal viability is performed under infrared light after intravenous infusion of 25 mg of indocyanine green. Case 1 is a 42-year-old male with multiple antecedents of severe vascular disease, presenting with a massive acute mesenteric ischemia involving multiple intestinal segments. Fluorescence allows two adjusted bowel resections with double intestinal anastomosis. Case 2 is a 74-year-old woman with a history of non-anticoagulated atrial fibrillation who is decided to perform an urgent surgery when an esophageal, gastric and portal system pneumatosis is observed, as indirect signs of ischemia, in urgent CT. During the surgical act there is an ischemia of the terminal ileum and right colon without clear signs of involvement at the esophageal-gastric level. The assessment after administration of ICG discriminates the clear ischemic involvement from terminal ileum to ascending colon and patched in the transverse and left colon, without esophageal or gastric involvement. Case 3 is a 49-year-old woman with aortoiliac and visceral Takayasu disease and revascularization surgery of the celiac trunk. Given the increase in abdominal pain, a new CT scan demonstrates colonic pneumatosis. Urgent laparotomy shows necrosis at the level of the left colon and hypoperfusion of the cecum. The administration of ICG finds a lack of uptake of the entire colon. A subtotal colectomy with ileostomy and mucous fistula is performed. Conclusions: The fluorescence with ICG provides a better visualization of the intestinal vascularization in the AMI, and allows to determine the limits of the affected tissue to perform adjusted resections.

scholarly journals Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery

2017 ◽  
Vol 12 (1) ◽  
Author(s):  
Miklosh Bala ◽  
Jeffry Kashuk ◽  
Ernest E. Moore ◽  
Yoram Kluger ◽  
Walter Biffl ◽  
...  
Keyword(s):  
Emergency Surgery ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
World Society ◽  
The World

Mesenteric Ischemia

2016 ◽  
Author(s):  
Ugo A. Ezenkwele
Keyword(s):  
Abdominal Pain ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Computed Tomographic Angiography ◽  
Low Flow ◽  
Chronic Mesenteric Ischemia ◽  
Flow State ◽  
Nonocclusive Mesenteric Ischemia ◽  
Vasodilator Therapy ◽  
Bowel Infarction

Acute mesenteric ischemia is interruption of intestinal blood flow by embolism, thrombosis, or a low-flow state. Bowel infarction is the end result of a process initiated by mediator release and inflammation. On clinical assessment, the early hallmark is severe abdominal pain but minimal physical findings. The abdomen remains soft, with little or no tenderness. Mild tachycardia may be present. Early diagnosis is difficult, but selective mesenteric angiography and computed tomographic angiography have the most sensitivity; other imaging studies and serum markers can show abnormalities but lack sensitivity and specificity early in the course of the disease, when diagnosis is most critical. Treatment is by embolectomy, anticoagulation, revascularization of viable segments, or resection; sometimes vasodilator therapy is successful. If diagnosis and treatment take place before infarction occurs, mortality is low; after intestinal infarction, mortality approaches 30 to 70%. For this reason, in the emergency department, clinical diagnosis should supersede diagnostic tests, which may delay treatment. This review contains 6 highly rendered figures, 4 tables, and 33 references. Key words: acute mesenteric ischemia; bowel necrosis; chronic mesenteric ischemia; mesenteric occlusive disease; mesenteric venous thrombosis; nonocclusive mesenteric ischemia; postprandial abdominal pain; superior mesenteric artery thromboembolism

scholarly journals Determinants of mortality and treatment outcome following surgical interventions for acute mesenteric ischemia

2007 ◽  
Vol 46 (3) ◽  
pp. 467-474 ◽  
Author(s):  
Panagiotis Kougias ◽  
Donald Lau ◽  
Hosam F. El Sayed ◽  
Wei Zhou ◽  
Tam T. Huynh ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Surgical Interventions

Surgical treatment of high-lying rectal neoplasms

1934 ◽  
Vol 30 (2) ◽  
pp. 189-189
Author(s):  
Ya. M. Iofan ◽  
A. A. Kudryavtsev
Keyword(s):  
Colon Cancer ◽  
Surgical Treatment ◽  
Mortality Rate ◽  
High Mortality ◽  
Rectal Neoplasms ◽  
The West ◽  
Surgical Interventions ◽  
Statistical Record

Currently, the dominant surgical interventions for high-lying rectal neoplasms are intraperitoneal and sacral methods. The latter methods, which are well established, have a great statistical record both in our Union and among surgeons in the West and America. However, we cannot say that we are completely satisfied with these methods: peritoneal-sacral method has a high mortality rate (47%), sacral method has less mortality but is also not without shadows. In the following lines we intend to describe the method applied by us on May 5, 1933, in case of high colon cancer of the patient M. Shchetinina, 39 years old.

Acute Portomesenteric Venous Thrombosis: Diagnosis and Treatment

2018 ◽  
Vol 02 (03) ◽  
pp. 249-255
Author(s):  
Stephen Allison ◽  
David Shin ◽  
Guy Johnson
Keyword(s):  
Venous Thrombosis ◽  
Endovascular Therapy ◽  
Medical Management ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Diagnosis And Treatment ◽  
Bowel Infarction ◽  
Radiologic Imaging ◽  
Portomesenteric Venous Thrombosis

AbstractAcute portomesenteric venous thrombosis (PMVT) is an unusual cause of acute mesenteric ischemia. Because of its rarity and nonspecific presentation, radiologic imaging plays a key role in the diagnosis of acute PMVT. Medical management with anticoagulation is the mainstay of therapy, with surgery reserved for patients suspected of having peritonitis or bowel infarction. However, endovascular therapy has an evolving role and may serve as an important adjunct to anticoagulation in selected patients with acute PMVT.

Arterial Endovascular Interventions in Acute Mesenteric Ischemia

2018 ◽  
Vol 02 (03) ◽  
pp. 210-216
Author(s):  
Geoffrey Miller ◽  
James Stone ◽  
Luke Wilkins
Keyword(s):  
Mesenteric Ischemia ◽  
Treatment Plan ◽  
Treatment Options ◽  
Traumatic Injury ◽  
Acute Mesenteric Ischemia ◽  
Medical Emergency ◽  
Cross Sectional ◽  
Bowel Infarction ◽  
Endovascular Interventions ◽  
Sudden Decrease

AbstractAcute mesenteric ischemia (AMI) is a true medical emergency and requires a multi-disciplinary treatment approach. AMI occurs when there is a sudden decrease in blood flow resulting in hypoperfusion to the intestines and may lead to bowel infarction. There are many potential etiologies of AMI that include arterial embolus, arterial, or venous thrombosis; traumatic injury; aortic dissection; intestinal obstruction; non-occlusive mesenteric ischemia, and vasculitis. Given mortality rates that approach 90%, rapid diagnosis is essential to decrease risk of bowel infarction. While surgical management has traditionally been the treatment of choice, endovascular management is being used with increasing frequency. Further, utilizing endovascular treatment options together with surgical intervention has shown promising results. The endovascular approach to treatment of AMI will depend on the underlying etiology. In addition, the acuity of patient presentation, presence, or absence of bowel infarction; patient stability; and availability of a hybrid operating room will influence the treatment plan of a patient with AMI. Early diagnosis with advanced cross-sectional imaging along with assessment of the underlying risk factors will optimize chances of early intervention and improve patient outcomes.

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