scholarly journals Endovascular treatment of unique colonic arteriovenous malformation with dual supply from superior and inferior mesenteric arteries

2021 ◽  
Vol 5 ◽  
pp. 7
Author(s):  
Lucas Richards ◽  
Aaron Rohr ◽  
Adam Alli ◽  
Steven Lemons
Keyword(s):  
Abdominal Pain ◽  
Mesenteric Artery ◽  
Arteriovenous Malformations ◽  
Inferior Mesenteric Artery ◽  
Case Series ◽  
Mesenteric Arteries ◽  
Treatment Level ◽  
Level Of Evidence ◽  
Hepatic Venous Congestion ◽  
Endovascular Approach

Colonic arteriovenous malformations (AVMs) are well recognized in the literature and commonly manifest as colitis, abdominal pain, and rare cases have been reported of liver congestion. Dual-supply superior artery/ inferior mesenteric artery (SMA/IMA) colonic AVMs have never been reported and only one case of treating portal hypertension due to an AVM with an endovascular approach has been reported. We present a case of dual-supply SMA/IMA colonic AVM manifesting as hepatic venous congestion and demonstrate an endovascular approach to treatment. Level of evidence: Level 4, case series.

Duplex ultrasound interpretation criteria for inferior mesenteric arteries

Vascular ◽  
2012 ◽  
Vol 20 (3) ◽  
pp. 145-149 ◽  
Author(s):  
Ali F AbuRahma ◽  
L Scott Dean
Keyword(s):  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Duplex Ultrasound ◽  
Mesenteric Arteries ◽  
Reasonable Accuracy ◽  
Diastolic Velocity ◽  
Interpretation Criteria ◽  
The Mean ◽  
Better Than ◽  
Mesenteric Arteriography

There is no specific duplex ultrasound (DUS) criteria for the diagnosis of inferior mesenteric artery (IMA) stenosis. This study will define the optimal duplex velocity values with the best overall accuracy (OA) in detecting ≥50% stenosis of the IMAs. Eighty-five IMAs with both DUS and mesenteric arteriography were analyzed. Eighty-five IMAs were examined: 45 were normal, 12 with <50% stenosis, eight with ≥50–69% stenosis and 15 with ≥70% stenosis (including occlusion) based on angiography. The mean peak systolic velocities (PSVs) for a normal IMA, <50% and ≥50% stenosis was 105, 215 and 392 cm/second, respectively ( P < 0.0001). The most accurate PSV in detecting ≥50% stenosis was ≥250 cm/second with a sensitivity of 90%, a specificity of 96% and an OA of 95%. The most accurate end-diastolic velocity (EDV) in detecting ≥50% stenosis was ≥80% or ≥90 cm/second, with an OA of 86%, a sensitivity of 60% and a specificity of 100%. The most accurate ratio in detecting ≥50% stenosis was ≥4 or ≥4.5 with an OA of 93%.Receiver operator curves analysis showed that the PSV was not better than EDV and PSV ratio in detecting ≥50% stenosis ( P = 0.1661 and 0.4568, respectively). In conclusion, specific IMA PSVs, EDVs and IMA/aortic systolic ratios can be used in detecting significant IMA stenosis with reasonable accuracy.

scholarly journals Spontaneous dissection of coeliac and superior mesenteric artery: double whammy

2021 ◽  
Vol 14 (3) ◽  
pp. e240047
Author(s):  
Kanhai Lalani ◽  
Tom Devasia ◽  
Ganesh Paramasivam
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Thrombus Formation ◽  
Hybrid Approach ◽  
Transluminal Angioplasty ◽  
Mesenteric Arteries ◽  
Visceral Artery ◽  
Bowel Rest

Isolated dissection of one of the mesenteric arteries without concurrent involvement of the aorta is a rare clinical entity and an unusual cause of abdominal pain. It usually involves one artery, most commonly the superior mesenteric artery (SMA) followed by the coeliac artery. We are reporting a rare case where both coeliac and SMA were showing dissection. We are reporting a case of 60-year-old hypertensive male who came with worsening abdominal pain for 5 days; CT scan showed coeliac and SMA dissection without any imaging evidence of intestinal ischaemia. He was successfully managed medically with bowel rest and anticoagulation. Two weeks of follow-up CT scan showed no progression or thrombus formation. For complicated cases, percutaneous transluminal angioplasty of a visceral artery or open surgical exploration or hybrid approach is required. However, for stable uncomplicated cases, medical therapy alone is sufficient.

scholarly journals OUTCOME OF NON-SURGICAL TREATMENT OF MALLET FINGER

2020 ◽  
Vol 28 (4) ◽  
pp. 172-176
Author(s):  
Stephan Alejandro Dávalos Barrios ◽  
Arturo Felipe de Jesús Sosa Serrano ◽  
Jorge Alberto Gama Herrera ◽  
Maria Fernanda Ramírez Berumen ◽  
Jose Manuel Pérez Atanasio
Keyword(s):  
Relative Risk ◽  
Conservative Treatment ◽  
Case Series ◽  
Treatment Level ◽  
Mallet Finger ◽  
Level Of Evidence ◽  
Distal Interphalangeal ◽  
Analytical Research ◽  
Crawford Classification ◽  
Non Surgical Treatment

ABSTRACT Objective: To establish the association between initial and residual angulation of the distal interphalangeal joint (DIJ) in mallet finger treated conservatively. Methods: An observational, prospective, descriptive and analytical research developed with uncomplicated closed mallet finger patients between January and December 2017. A total of two measurements of the DIJ were done, at the initial trauma and 6 weeks after conservative treatment. All measurements were ranked according to the Crawford Classification and Relative Risk was measured. Results: In total, 43 patients were studied, in which 53.48% of outcomes obtained were excellent. The sample was divided in two groups; one with less than 30º of DIJ initial angulation, which had 28% of residual angulation. The second group with more than 30º presented 72.22% of residual angulation. The Relative Risk to present a residual angulation in patients that had 30º of DIJ initial angulation was 2.99 (CI 95%) with p = 0.0059. Conclusion: It is suggested that patients with an initial DIJ angulation more than 30º are more likely to present residual angulation with conservative treatment. Level of Evidence IV, Case series.

Rupture prone aneurysm of the inferior mesenteric artery complicated by mid aortic syndrome with occluded celiac and superior mesenteric arteries

VASA ◽  
2011 ◽  
Vol 40 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Werth ◽  
Rodionov ◽  
Hinterseher ◽  
Beyer-Westendorf ◽  
Stroszczynski ◽  
...  
Keyword(s):  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Bypass Graft ◽  
Celiac Trunk ◽  
Mesenteric Arteries ◽  
Vascular Pathology ◽  
Vein Bypass ◽  
Large Aneurysm ◽  
Vein Bypass Graft ◽  
Saphenous Vein Bypass Graft

We present the case of a 45-year-old male patient with a large aneurysm of the inferior mesenteric artery complicated by mid aortic syndrome with occlusion of the celiac trunk and superior mesenteric artery. The vascular pathology was detected by CT imaging after presentation and hospitalization with symptoms of acute cholecystitis. After resolve of the acute symptoms, the aneurysm was resected and the proximal inferior mesenteric artery interponated with a reversed saphenous vein bypass graft. Besides presenting this case we review the literature concerning the rare descriptions of inferior mesenteric artery aneurysms.

Stenting of stenotic mesenteric arteries for symptomatic chronic mesenteric ischemia

VASA ◽  
2012 ◽  
Vol 41 (6) ◽  
pp. 425-431 ◽  
Author(s):  
Aschenbach ◽  
Bergert ◽  
Kerl ◽  
Zangos ◽  
Neumeister ◽  
...  
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Gastrointestinal Bleeding ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Celiac Artery ◽  
Lower Gastrointestinal Bleeding ◽  
Mesenteric Arteries ◽  
Chronic Mesenteric Ischemia ◽  
Technical Failure

Background: We report the results of our single center series of patients with chronic mesenteric ischemia (CMI) to determine the role of stenting in the management of patients. Patients and methods: We retrospectively reviewed all patients with CMI treated endovascularly with stent revascularisation from January 2008 to January 2011.CMI diagnosis was made according to clinical symptoms, including postprandial abdominal pain, food fear, and weight loss. Additionally, the diagnosis was confirmed by duplex ultrasonography and/or computed tomography angiography and/or contrast-enhanced magnetic resonance angiography. Results: All 45 patients presented with typical CMI symptoms: 45/45 (100 %) had postprandial pain, 31/45 (68.8 %) had a weight loss of more than 10 kilograms, and 11/45 (24.4 %) suffered from ischemic colitis combined with lower gastrointestinal bleeding. In three patients occlusion could not be crossed, therefore considered as technical failure. A total of 55 arteries were stented in the remaining 42 patients. Nineteen patients underwent SMA stenting alone, eight underwent celiac stenting, alone and three patients underwent stenting of inferior mesenteric artery (IMA) alone. We performed combined stenting of the celiac artery and superior mesenteric artery in ten patients, and one patient underwent a combined stenting of the celiac artery and the IMA. All three mesenteric arteries were stented in only one patient. Primary technical success was achieved in 42/45 (94.8 %) patients. Clinical symptom relief was achieved in 39/45 (86.6 %) patients with abdominal pain. Increased body weight was observed in 28/31 (90.3 %) patients with an average weight gain of 8.8 kilograms (5 - 12 kilograms), and 10/11 (90.9 %) patients recovered from ischaemic colitis/lower gastrointestinal bleeding. Conclusions: Stent revascularisation can be considered as the first-line therapy for patients with chronic mesenteric ischemia.

Case 16.6

2014 ◽  
pp. 767-768
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Celiac Artery ◽  
Severe Stenosis

79-year-old with abdominal pain and nausea VR images from 3D CE MRA (Figure 16.6.1) demonstrate occlusion of the celiac artery, severe stenosis of the superior mesenteric artery origin, and a patent inferior mesenteric artery with a prominent arc of Riolan. Coronal SSFSE images (...

Case 9.27

2014 ◽  
pp. 474-475 ◽  
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Celiac Artery ◽  
Mesenteric Vessel ◽  
Plain Radiographs ◽  
Contrast Enhanced ◽  
Partial Small Bowel Obstruction

59-year-old woman with abdominal pain and partial small-bowel obstruction visualized on plain radiographs A volume-rendered image from 3D contrast-enhanced MRA (Figure 9.27.1) shows the presence of a single mesenteric vessel, the celiac artery. The SMA and the inferior mesenteric artery are not visualized. Coronal SSFSE (...

scholarly journals Clinical implications of chronic mesenteric ischemia in elderly and senile patients

2020 ◽  
Vol 92 (2) ◽  
pp. 74-80
Author(s):  
A. I. Dolgushina ◽  
A. S. Kuznecova ◽  
A. A. Seljanina ◽  
V. V. Genkel ◽  
A. G. Vasilenko
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Celiac Trunk ◽  
Mesenteric Arteries ◽  
Chronic Mesenteric Ischemia ◽  
Clinical Criteria

Aim.To evaluate the sensitivity and specificity of the clinical criteria for the diagnosis of chronic mesenteric ischemia in elderly and senile patients with mesenteric atherosclerosis. Materials and methods.The study included 142 patients (82 men and 60 women). The median age of patients is 66.0 [62.0; 72.0] years. Results.According to MDCT atherosclerotic lesions of the abdominal aorta and its unpaired visceral branches were diagnosed in 105 (73.9%) patients. A combination of atherosclerosis of the celiac trunk and the superior mesenteric artery with the presence of hemodynamically insignificant stenosis was revealed. Hemodynamically significant atherosclerotic narrowing of at least one mesenteric artery was present in 15% of cases. Among them, a single vascular lesion was found in 6 patients (4.2%), a combination of hemodynamically significant lesions of two arteries in 15 (11%) patients. Depending on the clinical manifestations, all patients are divided into two groups: the first group 30 (21.1%) patients with the presence of symptoms characteristic of chronic mesenteric ischemia (CMI). The second group consisted of 112 (78.8%) patients without a characteristic triad of symptoms. The clinical symptom complex of СMI, including postprandial abdominal pain, intestinal dysfunction and progressive weight loss, as a diagnostic criterion showed low sensitivity 13.3% and specificity 77.9%. At the same time, the sensitivity of such a clinical combination as a combination of atherosclerosis of the arteries of the lower extremities, weight loss and abdominal pain syndrome with a severity of more than 5.5 points, with respect to the detection of hemodynamically significant stenoses of two or more mesenteric arteries was sensitivity 86.7%, specificity 74.0%.

scholarly journals DOUBLE FEMORAL OSTEOTOMY FOR THE TREATMENT OF SEVERE SEQUELAE OF THE IMMATURE HIP

2020 ◽  
Vol 28 (6) ◽  
pp. 287-290
Author(s):  
MARIANA DEMÉTRIO DE SOUSA PONTES ◽  
PAULO HENRIQUE BORTOLIN ◽  
JOSÉ BATISTA VOLPON
Keyword(s):  
Lower Limb ◽  
Therapeutic Option ◽  
Slipped Capital Femoral Epiphysis ◽  
Case Series ◽  
Gluteus Medius ◽  
Developmental Dysplasia ◽  
Femoral Osteotomy ◽  
Treatment Level ◽  
Level Of Evidence ◽  
Pelvic Support

ABSTRACT Objective: To evaluate the results of double femoral osteotomy for the treatment of severe sequelae of the hip. Methods: Immature patients with anatomical loss of the hip were treated with pelvic support osteotomy in the distal femur to correct lower limb shortening, they were evaluated clinically and radiographically. Results: Eleven cases (eleven hips) were assessed with verage follow-up of three years. The mean age of the patients was 14.7 years. Seven patients had sequela of infectious arthritis; three had sequela of developmental dysplasia of the hip and one patient had a sequela of slipped capital femoral epiphysis. Preoperatively, the gluteus medius was insufficient in all patients, and it became negative in ten of them. The average of lower limb shortening was 5 cm (2.5 to 7 cm) and reduced shortening was 1.9 cm (0 to 4 cm). According to Paley Classification, 72.7% of complications were considered problems, 90.9% were considered obstacles and 27.2% complications, among which the limitation of the knee flexion was the most frequent. Conclusion: The technique yielded good results, considering the severity of the sequela and the absence of a better therapeutic option. No important sequela was associated with the treatment. Level of Evidence IV, Case series.

scholarly journals Intestinal Ischemia Mirrors Cardiac Angina- A Case Report

2021 ◽  
pp. 5-9
Author(s):  
Sunil Dighe ◽  
Kalyan Munde ◽  
Piyush Kalantri ◽  
Mahesh Bodke
Keyword(s):  
Blood Flow ◽  
Abdominal Pain ◽  
Endovascular Treatment ◽  
Mesenteric Artery ◽  
Celiac Artery ◽  
The Body ◽  
Mesenteric Arteries ◽  
Long Term Results ◽  
Chronic Mesenteric Ischemia ◽  
Interventional Devices

Chronic mesenteric ischemia (intestinal angina) is a condition that is caused by stenosis or occlusion of the mesenteric arteries (Superior mesenteric artery, inferior mesenteric artery and celiac artery) and usually manifest as abdominal pain which is usually post - prandial in nature. If plaque or lesion in an artery supplying the intestines narrows the vessel so severely that sluggish blood flow causes a clot, blood flow through that artery can become completely blocked, which can lead to ischemia .While surgical revascularization has been the standard treatment for symptomatic patients in past , recent advances in interventional devices and techniques have made endovascular treatment easily available and effective treatment. Endovascular treatment is considered as minimally invasive means of obtaining good long-term results. The Coronary arteries are common hiding places for cholesterol-filled plaque and blood clots. Plaque can limit blood flow during exercise or stress, causing the chest pain or pressure known as angina. Clots may completely block blood flow, causing a heart attack or cardiac arrest. These two leading perpetrators can do similar things elsewhere in the body. When they interfere with blood flow to the digestive system, the effects can range from a stomach ache after every meal to a life threatening emergency. We report a similar case who present with unstable angina. During hospitalization he was having persistent abdominal pain and who was investigated with CT abdomen and later Angioplasty was done which further showed significant benefit to patient.

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