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Acute Mesenteric Ischemia

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Source Control

Abstract

• Maintain a high degree of suspicion: the primary goal is diagnosis prior to bowel infarction — a complication that carries a mortality of up to 90% [1, 2]. • Aggressive use of angiography to make the correct diagnosis and plan surgical intervention appropriately. • Restoration of bowel perfusion requires not only surgical intervention but also aggressive use of invasive monitoring to assure adequate resuscitation. • Following resection of devitalized bowel, make a plan for a second-look procedure based on the appearance of the bowel.

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References

  1. Klempnauer J, Grothues F, Bektas H, Pichlmayr R (1997) Long-term results after surgery for acute mesenteric ischemia. Surgery 121:239–243

    Article  PubMed  CAS  Google Scholar 

  2. Montgomery RA, Venbrux AC, Bulkley GB (1997) Mesenteric vascular insufficiency. Curr Probl Surg 34:941–1025

    Article  PubMed  CAS  Google Scholar 

  3. Boley SJ, Brandt LJ, Sammartano RJ (1997) History of mesenteric ischemia: the evolution of a diagnosis and management. Surg Clin North Am 77:275–288

    Article  PubMed  CAS  Google Scholar 

  4. Smerud MJ, Johnson CD, Stephens DH (1990) Diagnosis of bowel infarction: a comparison of plain films and CT scans in 23 cases. AJR Am J Roentgenol 154:99–103

    PubMed  CAS  Google Scholar 

  5. Eldrup-Jorgensen J, Hawkins RE, Bredenberg CE (1997) Abdominal vascular catastrophes. Surg Clin North Am 77:1305–1320

    Article  PubMed  CAS  Google Scholar 

  6. Boley SJ, Kaleya RN, Brandt LJ (1992) Mesenteric venous thrombosis. Surg Clin North Am 72:183–201

    PubMed  CAS  Google Scholar 

  7. Rhee RY, Gloviczki P, Mendonca CT, et al (1994) Mesenteric venous thrombosis: still a lethal disease in the 1990s. J Vasc Surg 20:688–697

    Article  PubMed  CAS  Google Scholar 

  8. Bassiouny HS (1997) Nonocclusive mesenteric ischemia. Surg Clin North Am 77:319–326

    Article  PubMed  CAS  Google Scholar 

  9. Kaleya RN, Sammartano RJ, Boley SJ (1992) Aggressive approach to acute mesenteric ischemia. Surg Clin North Am 72:157–182

    PubMed  CAS  Google Scholar 

  10. Boley SJ, Sprayregan S, Siegelman SS, Veith FJ (1977) Initial results from an aggressive roentgenological and surgical approach to acute mesenteric ischemia. Surgery 82:848–855

    PubMed  CAS  Google Scholar 

  11. Bakal CW, Sprayregen S, Wolf EL (1992) Radiology in intestinal ischemia. Angiographic diagnosis and management. Surg Clin North Am 72:125–141

    CAS  Google Scholar 

  12. Haglund U (1994) Gut ischaemia. Gut 35[Suppl]:S73–S76

    Article  PubMed  CAS  Google Scholar 

  13. Herndon DN, Zeigler ST (1993) Bacterial translocation after thermal injury. Crit Care Med 21[Suppl]:S50–S54

    Article  PubMed  CAS  Google Scholar 

  14. Tokyay R, Zeigler ST, Traber DL, et al (1993) Postburn gastrointestinal vasoconstriction increases bacterial and endotoxin translocation. J Appl Physiol 74:1521–1527

    Article  PubMed  CAS  Google Scholar 

  15. Andersen LW, Landow L, Baek L, Jansen E, Baker S (1993) Association between gastric intramucosal pH and splanchnic endotoxin, antibody to endotoxin, and tumor necrosis factor-alpha concentrations in patients undergoing cardiopulmonary bypass. Crit Care Med 21: 210–217

    Article  PubMed  CAS  Google Scholar 

  16. Schoeffel U, Baumgartner U, Imdahl A, Haering R, v Specht BU, Farthmann EH (1997) The influence of ischemic bowel wall damage on translocation, inflammatory response, and clinical course. Am J Surg 174:39–44

    Article  PubMed  CAS  Google Scholar 

  17. Kazmers A (1998) Operative management of acute mesenteric ischemia. Part 1. Ann Vasc Surg 12:187–197

    Article  CAS  Google Scholar 

  18. Cappell MS (1998) Intestinal (mesenteric) vasculopathy. I. Acute superior mesenteric arteriopathy and venopathy. Gastroenterol Clin North Am 27:783–825

    Article  PubMed  CAS  Google Scholar 

  19. McKinsey JF, Gewertz BL (1997) Acute mesenteric ischemia. Surg Clin North Am 77:307–318

    Article  PubMed  CAS  Google Scholar 

  20. Redaelli CA, Schilling MK, Buchler MW (1998) Intraoperative laser Doppler flowmetry: a predictor of ischemic injury in acute mesenteric infarction. Dig Surg 15:55–59

    Article  PubMed  CAS  Google Scholar 

  21. Ballard JL, Stone WM, Hallett JW, Pairolero PC, Cherry KJ (1993) A critical analysis of adjuvant techniques used to assess bowel viability in acute mesenteric ischemia. Am Surg 59:309–311

    PubMed  CAS  Google Scholar 

  22. Bulkley GB, Zuidema GD, Hamilton SR, O'Mara CS, Klacsmann PG, Horn SD (1981) Intraoperative determination of small intestinal viability following ischemic injury: a prospective, controlled trial of two adjuvant methods (Doppler and fluorescein) compared with standard clinical judgment. Ann Surg 193:628–637

    Article  PubMed  CAS  Google Scholar 

  23. Horgan PG, Gorey TF (1992) Operative assessment of intestinal viability. Surg Clin North Am 72:143–155

    PubMed  CAS  Google Scholar 

  24. Paes E, VoUmar JF, Hutschenreiter S, Schoenberg MH, Kubel R, Scholzel E (1988) [Mesenterial infarct. New aspects of diagnosis and therapy]. Chirurg 59:828–835

    PubMed  CAS  Google Scholar 

  25. Mann A, Fazio VW, Lucas FV (1982) A comparative study of the use of fluorescein and the Doppler device in the determination of intestinal viability. Surg Gynecol Obstet 154:53–55

    PubMed  CAS  Google Scholar 

  26. Schneider TA, Longo WE, Ure T, Vernava AM 3rd (1994) Mesenteric ischemia: acute arterial syndromes [see comments]. Dis Colon Rectum 37:1163–1174

    Article  PubMed  CAS  Google Scholar 

  27. Bradbury AW, Brittenden J, McBride K, Ruckley CV (1995) Mesenteric ischaemia: a multidis-ciplinary approach [see comments]. Br J Surg 82:1446–1459

    Article  PubMed  CAS  Google Scholar 

  28. Rhee RY, Gloviczki P (1997) Mesenteric venous thrombosis. Surg Clin North Am 77:327–338

    Article  PubMed  CAS  Google Scholar 

  29. Bohnen JM, Solomkin JS, Dellinger EP, Bjornson HS, Page CP. Guidelines for clinical care: anti-infective agents for intra-abdominal infection. A Surgical Infection Society policy statement. Arch Surg 127:83–89

    Google Scholar 

  30. Schein M, Wittmann DH, Lorenz W. Duration of antibiotic treatment in surgical infections of the abdomen. Forum statement: a plea for selective and controlled postoperative antibiotic administration. Eur J Surg Suppl 57:66–69

    Google Scholar 

  31. Dunn MM, McFall TA, Rigano WD, Peoples JB (1993) Adjunctive vasodilator therapy in the treatment of murine ischemia. Am J Surg 165:697–699

    Article  PubMed  CAS  Google Scholar 

  32. MacCannell KL (1986) Comparison of an intravenous selective mesenteric vasodilator with intraarterial papaverine in experimental nonocclusive mesenteric ischemia. Gastroenterology 91 79–83

    PubMed  CAS  Google Scholar 

  33. Williams RA, Wilson SE (1980) Effect of intra-arterial vasodilators on blood flow in ischemic dog colon. Arch Surg 115:602–605

    Article  PubMed  CAS  Google Scholar 

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© 2003 Springer-Verlag Berlin Heidelberg

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Raymond, D.P., May, A.K. (2003). Acute Mesenteric Ischemia. In: Schein, M., Marshall, J.C. (eds) Source Control. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55914-3_36

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  • DOI: https://doi.org/10.1007/978-3-642-55914-3_36

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-00408-0

  • Online ISBN: 978-3-642-55914-3

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