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1.
Korean Journal of Radiology ; : 736-743, 2015.
Article in English | WPRIM | ID: wpr-22497

ABSTRACT

OBJECTIVE: To evaluate the technical feasibility and clinical outcome of percutaneous aspiration embolectomy for embolic occlusion of the superior mesenteric artery (SMA). MATERIALS AND METHODS: Between January 2010 and December 2013, 9 patients with embolic occlusion of the SMA were treated by percutaneous aspiration embolectomy in 2 academic teaching hospitals. The aspiration embolectomy procedure was performed with the 6-Fr and 7-Fr guiding catheter. Thrombolysis was performed with urokinase using a multiple-sidehole infusion catheter. The clinical outcome was investigated retrospectively. RESULTS: Superior mesenteric artery occlusion was initially diagnosed by computed tomography (CT) in all patients, and all patients had no obvious evidence of bowel infarction on CT scan. Percutaneous aspiration embolectomy was primarily performed in 6 patients, and thrombolysis was initially performed in 3 patients. In 3 patients who received primary thrombolysis, percutaneous aspiration was undertaken because the emboli were resistant to urokinase. Complete angiographic success was achieved in 6 patients and partial angiographic success was accomplished in 3 patients. One patient underwent bowel resection. One patient died of whole bowel necrosis and sepsis, and 8 patients survived without complications. CONCLUSION: Percutaneous aspiration embolectomy is a useful tool in recanalization of embolic occlusion of the SMA in select patients.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Angiography/methods , Embolectomy/methods , Embolism/complications , Mesenteric Artery, Superior/diagnostic imaging , Mesenteric Vascular Occlusion/etiology , Retrospective Studies , Suction/instrumentation , Thrombolytic Therapy/methods , Tomography, X-Ray Computed , Treatment Outcome , Urokinase-Type Plasminogen Activator/administration & dosage , Vascular Access Devices
2.
Yonsei Medical Journal ; : 859-862, 2011.
Article in English | WPRIM | ID: wpr-182765

ABSTRACT

Acutely aggravated dissecting flap and consequent occlusion of the superior mesenteric artery (SMA) by simple contrast passage during initial angiography for percutaneous stent placement is a uncommon event, which usually is not reported. After analysis of many factors that underlie development of such complications, we present herein one case of successful treatment of isolated SMA dissection and its complications with favorable outcomes during 25 months follow-up after percutaneous stent placement.


Subject(s)
Adult , Humans , Male , Aortic Dissection/surgery , Angiography/adverse effects , Contrast Media/adverse effects , Embolectomy , Mesenteric Artery, Superior/diagnostic imaging , Mesenteric Vascular Occlusion/etiology , Stents/adverse effects , Tomography, X-Ray Computed
3.
The Korean Journal of Gastroenterology ; : 58-61, 2010.
Article in Korean | WPRIM | ID: wpr-138051

ABSTRACT

Isolated spontaneous dissection of the superior mesenteric artery (SMA) without aortic dissection is a rare cause of acute mesenteric ischemia. A sudden decrease of intestinal blood flow can lead to fatal complications such as ischemic necrosis, shock, and death. Therefore, early diagnosis and therapeutic approach before the occurrence of intestinal infarction are the most important factor to determine the patient's prognosis. A 52-year-old male presented with postprandial periumbilical pain, and isolated spontaneous dissection of the superior mesenteric artery with mural thrombus was detected by abdominal computed tomography with contrast enhancement. By the percutaneous implantation of vascular metallic stent via femoral artery, he was treated successfully. We report a case of isolated spontaneous dissection of the SMA treated by a percutaneous endovascular stent replacement with a review of literature.


Subject(s)
Humans , Male , Middle Aged , Aortic Dissection/complications , Mesenteric Artery, Superior/diagnostic imaging , Mesenteric Vascular Occlusion/etiology , Stents , Tomography, X-Ray Computed
4.
The Korean Journal of Gastroenterology ; : 58-61, 2010.
Article in Korean | WPRIM | ID: wpr-138050

ABSTRACT

Isolated spontaneous dissection of the superior mesenteric artery (SMA) without aortic dissection is a rare cause of acute mesenteric ischemia. A sudden decrease of intestinal blood flow can lead to fatal complications such as ischemic necrosis, shock, and death. Therefore, early diagnosis and therapeutic approach before the occurrence of intestinal infarction are the most important factor to determine the patient's prognosis. A 52-year-old male presented with postprandial periumbilical pain, and isolated spontaneous dissection of the superior mesenteric artery with mural thrombus was detected by abdominal computed tomography with contrast enhancement. By the percutaneous implantation of vascular metallic stent via femoral artery, he was treated successfully. We report a case of isolated spontaneous dissection of the SMA treated by a percutaneous endovascular stent replacement with a review of literature.


Subject(s)
Humans , Male , Middle Aged , Aortic Dissection/complications , Mesenteric Artery, Superior/diagnostic imaging , Mesenteric Vascular Occlusion/etiology , Stents , Tomography, X-Ray Computed
5.
The Korean Journal of Gastroenterology ; : 168-172, 2006.
Article in Korean | WPRIM | ID: wpr-198251

ABSTRACT

Acute mesenteric ischemia can result from emboli, arterial and venous thrombi or vasoconstriction secondary to low-flow states. Isolated spontaneous dissection of the superior mesenteric artery is a rare cause of acute mesenteric ischemia. The mortality rates of acute mesenteric ischemia averages 71% with a range of 59-93%. Diagnosis before the occurrence of intestinal infarction is the most important factor in improving survival rate for patients with acute mesenteric ischemia. A 68-year-old female presented with postprandial epigastric pain, and a dissection of the superior mesenteric artery and a gallbladder polyp were shown in abdominal computed tomographic scan. After the percutaneous metalic stent placement and laparoscopic cholecystectomy, her symptoms improved. We report a case of spontaneous dissection of main trunk of the superior mesenteric artery which was successfully treated by percutaneous stent placement with a review of literature.


Subject(s)
Aged , Female , Humans , Acute Disease , Aortic Dissection/complications , Angioplasty, Balloon , Ischemia/etiology , Mesenteric Artery, Superior , Mesenteric Vascular Occlusion/etiology , Stents
7.
Rev. argent. cir ; 86(3/4): 87-92, mar.-abr. 2004. tab
Article in Spanish | LILACS | ID: lil-397628

ABSTRACT

Antecedentes: La isquemia intestinal tiene una mortalidad mayor al 70 por ciento. Su diagnóstico es un desafío. No existe estudio de certeza para determinar su presencia. El Dímero D (DD) es un marcador de fibrinolisis. Se aplica en el diagnóstico de la trombosis venosa profunda y el tromboembolismo pulmonar. Su nivel plasmático elevado indicaría la presencia de isquemia intestinal aguda (IIA) por enfermedad trombólica. Objetivo: Determinar el valor diagnóstico del DD en la IIA de cualquier etiología. Lugar de aplicación: Hospital Privado de la Comunidad. Diseño: Longitudinal, consecutivo, prospectivo no randomizado. Período: 2001-2002. Población: Determinación de DD en 26 pacientes con diagnóstico presuntivo de IIA. Métodos: Se analizaron la sensibilidad (S), especificidad (E), valor predictivo negativo (VPN) y positivo (VPP) del DD para determinar la IIA (Epidat 2,1). Resultados: Se comprobó la ausencia de isquemia intestinal en 6 casos, en todos ellos el DD fue negativo. En los 4 casos tratados médicamente no se pudo certificar isquemia, asimismo el DD fue negativo. Dichos pacientes evolucionaron favorablemente sin necesidad de cirugía. En 15 de los 16 casos con certeza de isquemia el DD fue positivo. La S del DD para diagnosticar isquemia fue de 93,3 por ciento - VPN 87,5 por ciento - E y VPP, 100 por ciento (Alfa=0,05)


Subject(s)
Humans , Male , Adult , Female , Middle Aged , Ischemia , Mesenteric Vascular Occlusion/diagnosis , Colon , Enzyme-Linked Immunosorbent Assay , Intestine, Small , Ischemia , Biomarkers/blood , Mesenteric Artery, Superior , Mesenteric Vascular Occlusion/etiology , Mesenteric Vascular Occlusion/mortality , Predictive Value of Tests , Prospective Studies , Sensitivity and Specificity , Latex Fixation Tests , Thromboembolism
8.
Article in English | IMSEAR | ID: sea-65474

ABSTRACT

We report two patients, one with liver cirrhosis and another with extrahepatic portal vein obstruction, who developed acute mesenteric vein thrombosis following endoscopic variceal sclerotherapy with absolute alcohol. Both patients recovered after emergency laparotomy and resection of gangrenous bowel loop.


Subject(s)
Adolescent , Adult , Ethanol/therapeutic use , Female , Humans , Mesenteric Vascular Occlusion/etiology , Mesenteric Veins , Sclerotherapy/adverse effects , Venous Thrombosis/etiology
10.
Rev. méd. Maule ; 20(1): 22-5, jun. 2001. ilus
Article in Spanish | LILACS | ID: lil-296056

ABSTRACT

La isquemia mesentérica aguda aún no es considerada en muestro medio dentro de las hipótesis diagnósticas de un paciente con un cuadro abdominal agudo, además la reticencia de muchos colegas para indicar estudio angiográfico o la falta de disponibilidad inmediata de éste, es otro punto en contra. Lo anteriormente expuesto determina la diferencia entre isquemia e infarto intestinal y no permite modificar sustancialmente el resultado final del paciente


Subject(s)
Humans , Ischemia/diagnosis , Mesenteric Artery, Superior/anatomy & histology , Mesenteric Vascular Occlusion/diagnosis , Venous Thrombosis/diagnosis , Intestines/blood supply , Ischemia/etiology , Mesenteric Vascular Occlusion/etiology , Mesenteric Vascular Occlusion/physiopathology
11.
Rev. méd. Chile ; 127(11): 1369-74, nov. 1999. ilus, tab
Article in Spanish | LILACS | ID: lil-257997

ABSTRACT

We report a 24 years old female with a superior mesenteric and portal vein thrombosis due to an antithrombin III factor deficiency, associated to oral contraceptive use and smoking. She presented with severe abdominal pain and the diagnosis was reached after surgery with a CT scan. The patient was treated with intravenous heparin and oral anticoagulation, with a good clinical and doppler endosonographic response. One month after the onset, she developed an intestinal occlusion caused by two concentric jejunal stenoses, measuring 2 and 0.7 cm in length and demonstrated with a barium jejunogram. A 35 cm intestinal resection was done and the patient recovered uneventfully. The pathological study showed granulation tissue on both stenotic zones with an ulcer near to the distal stricture, that reached the internal muscularis propria, with subserosal fibrosis. The development of segmental stenosis is a rare complication superior mesenteric vein thrombosis, that must be bore in mind


Subject(s)
Humans , Female , Adult , Thrombosis , Intestinal Obstruction/etiology , Mesenteric Vascular Occlusion/complications , Portal Vein , Antithrombin III Deficiency , Anticoagulants/therapeutic use , Intestinal Obstruction/surgery , Intestinal Obstruction/diagnosis , Mesenteric Vascular Occlusion/diagnosis , Mesenteric Vascular Occlusion/etiology , Mesenteric Veins
13.
Rev. argent. cir ; 73(5): 125-8, nov. 1997. ilus
Article in Spanish | LILACS | ID: lil-207987

ABSTRACT

Las neoplasias del intestino delgado son poco frecuentes. Los carcinoides son el 20 por ciento de éstas. La mayoría son asintomáticos y son hallazgos incidentales, el resto se presenta por sus complicaciones, como cuadros agudos de abdomen, el más frecuente es la oclusión intestinal. El infarto intestino mesentérico y la isquemia intestinal han sido reconocidos como otra presentación muy rara, en estos casos la terapéutica quirúrgica agresiva, a pesar de la gravedad de la presentación, muestra beneficios en el pronóstico. Se presentan 2 casos y se discuten los eventos patogénicos


Subject(s)
Humans , Male , Female , Middle Aged , Carcinoid Tumor/complications , Intestinal Neoplasms/complications , Mesenteric Vascular Occlusion/etiology , Carcinoid Tumor , Carcinoid Tumor/diagnosis , Intestinal Neoplasms , Intestinal Neoplasms/secondary , Intestine, Small/blood supply , Ischemia/etiology , Intestinal Obstruction/etiology , Prognosis , Survival Rate
15.
HB cient ; 4(1): 50-3, jan.-abr. 1997.
Article in Portuguese | LILACS | ID: lil-214114

ABSTRACT

Relata-se o caso de uma paciente de 47 anos de idade que procurou o serviço de cirurgia do Hospital de Base - FAMERP (SP) com queixas de dor abdominal em cólica na regiao hipogástrica, náuseas, vômitos e diarréia nao sanguinolenta há um dia. No exame físico encontrava-se taquicárdica, hipotensao e com dor à descompressao brusca do abdome em regiao hipogástrica. Foi submetida a laparotomia exploradora com diagnóstico de trombose de vei mesentérica superior. Constatou-se a positividade para o anticoagulante lúpico com ausência de anticorpos anticardiolipinas, proteína S e C e antitrombina III. Realizou-se a anticoagulaçao com heparina e mesmo na vigência desta apresentou progressao do quadro trombótico com necessidade de novas ressecçoes. Chama-se atençao para a necessidade de se investigar as causas trombogênicas em pacientes com trombose da veia mesentérica superior.


Subject(s)
Humans , Female , Middle Aged , Antibodies, Antiphospholipid/isolation & purification , Mesenteric Vascular Occlusion/etiology , Thrombosis/etiology , Anticoagulants/therapeutic use , Heparin/therapeutic use , Mesenteric Artery, Superior , Mesenteric Veins , Mesenteric Vascular Occlusion/drug therapy , Thrombosis/drug therapy
17.
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo ; 51(2): 65-68, Mar.-Apr. 1996.
Article in Portuguese | LILACS | ID: lil-320226

ABSTRACT

The consequence of an acute mesenteric venous thrombosis following porta-azygos disconnection for the treatment of bleeding esophageal varices due to mansonian schistosomiasis has not been well defined in the literature. The clinical manifestations reported were fever, spasmodic abdominal pain associated with food intake. We treated three patients with thrombosis of the portal-mesenteric trunk following porta-azygos disconnection and adopted a conservative clinical approach in two patients while one had to have a surgical small bowel ressection.


Subject(s)
Humans , Male , Adult , Gastrointestinal Hemorrhage , Mesenteric Vascular Occlusion/etiology , Postoperative Complications , Thrombosis , Esophageal and Gastric Varices/surgery , Gastrointestinal Hemorrhage , Portal Vein , Schistosomiasis mansoni , Splenectomy , Esophageal and Gastric Varices/etiology , Azygos Vein/surgery
18.
Pesqui. méd. (Porto Alegre) ; 23(1): 18-21, 1989. tab
Article in Portuguese | LILACS | ID: lil-81166

ABSTRACT

No presente trabalho os autores apresentam uma forma sistemática de diagnóstico clínico e/ou cirúrgico para o abdômen agudo de origem vascular, enfatizando a importância da suspeita diagnóstica e da terapêutica precoce na sobrevida dos pacientes


Subject(s)
Humans , Male , Female , Abdomen, Acute/complications , Abdomen, Acute/diagnosis , Acute Disease , Mesenteric Vascular Occlusion/etiology
19.
Rev. Col. Bras. Cir ; 15(5): 321-2, set.-out. 1988.
Article in Portuguese | LILACS | ID: lil-73046

ABSTRACT

Os autores apresentam um caso de isquemia mesentérica aguda em paciente portador de tromboangiitr obliterante. Discutem a raridade do comprometimento intestinal na doença em questäo, assim como as formas de diagnosticá-la


Subject(s)
Adult , Humans , Male , Mesenteric Vascular Occlusion/etiology , Thromboangiitis Obliterans/diagnosis , Ischemia/etiology , Mesenteric Vascular Occlusion/surgery , Postoperative Complications , Smoking , Thromboangiitis Obliterans/diagnosis
20.
Rev. Col. Bras. Cir ; 12(3): 96-100, maio-jun. 1985. tab, ilus
Article in Portuguese | LILACS | ID: lil-1987

ABSTRACT

Embora os fenômenos trombembólicos pós-esplenectomia sejam bem conhecidos, a trombose venosa de mesentérica é entidade rara e de alta gravidade. Neste trabalho säo analisados 10 doentes com esta complicaçäo que ocorreu o 7- e 38- dia pós-operatório da esplenectomia. Oito doentes foram operados, sendo submetidos a enterectomias parciais que variaram de 50 a 300 cm de extensäo. Dois foram tratados clínicamente. A mortalidade global foi de 30%


Subject(s)
Adult , Middle Aged , Humans , Male , Female , Mesenteric Vascular Occlusion/etiology , Splenectomy/adverse effects , Thrombosis/etiology
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