An arteriographic study of mesenteric arterial disease. I. Large vessel changes.

Dick, Anastasia; Graff, Rex; Gregg, Duncan; Peters, Nicholas; Sarner, M.

doi:10.1136/gut.8.3.206

Cited by 38 publications

(6 citation statements)

References 23 publications

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“…Altered flow patterns in either of these two ways, if generally applicable, would allow this unique situation of intermittent visceral artery obstruction to give rise to symptoms on a vascular basis, without violating the previously held view that the collateral potential of the visceral bed required more than one artery (or its equivalent) to be lost before ischaemia is provoked (Dick et al, 1967;Rob, 1967). The collateral around the coeliac axis is particularly rich, and Michels (1955) cited 26 possible collateral pathways to the liver, other than the typical coeliac axis supply, and at least 16 of these are relevant to obstruction at its origin.…”

Section: Discussionmentioning

confidence: 99%

“…Bron, 1966). In the first place it runs contrary to the view that the equivalent of more than one of the visceral arteries need to be occluded before mesenteric ischaemia is provoked (Rob, 1967;Dick et al, 1967). Secondly, typical angiographic appearances may be shown in asymptomatic people (Sutton, 1967), and Drapanas and Bron (1966) Compression Syndrc an upper paramedian incision, when good access was obtained through the gastrohepatic omentum.…”

Section: Patients and Surgical Proceduresmentioning

confidence: 95%

See 1 more Smart Citation

Experience with Coeliac Axis Compression Syndrome

Edwards¹,

Hamilton²,

Nichol³

et al. 1970

BMJ

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Section: Discussionmentioning

confidence: 99%

Section: Patients and Surgical Proceduresmentioning

confidence: 95%

Experience with Coeliac Axis Compression Syndrome

Edwards¹,

Hamilton²,

Nichol³

et al. 1970

BMJ

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“…Symptomatic chronic gastrointestinal ischaemia is rarely diagnosed1-4 despite a relatively high prevalence of significant splanchnic atherosclerosis in angiographic5 6and autopsy studies 78 This discrepancy is explained by the abundant collateral circulation of the gastrointestinal tract, preventing ischaemia if a single vessel has been occluded 1…”

mentioning

confidence: 99%

Increased gastric Pco ₂ during exercise is indicative of gastric ischaemia: a tonometric study

Kolkman

Groeneveld

Berg

et al. 1999

Gut

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Background-Diagnosis of gastric ischaemia is diYcult and angiography is an invasive procedure. Angiographic findings may not correlate with clinical importance. Aims-To investigate whether tonometric measurement of intragastric PCO 2 during exercise can be used to detect clinically important gastric ischaemia. Methods-Fourteen patients with unexplained abdominal pain or weight loss were studied. Splanchnic angiography served as the gold standard. Three patients were studied again after a revascularisation procedure. Gastric PCO 2 was measured from a nasogastric tonometer, with 10 minute dwell times, and after acid suppression. Gastric and capillary PCO 2 were measured before, during, and after submaximal exercise of 10 minutes duration. Results-Seven patients had normal angiograms; seven had more than 50% stenosis in the coeliac (n=7) or superior mesenteric artery (n=4). Normal subjects showed no changes in tonometry. In patients with stenoses, the median intragastric PCO 2 (PiCO 2 ) at rest was 5.2 kPa (range 4.8-11.2) and rose to 6.4 kPa (range 5.7-15.7) at peak exercise; the median intragastric blood PCO 2 gradient increased from 0.0 kPa (range −0.8 to 5.9) to 1.7 kPa (range 0.9 to 10.3; p<0.01). Only two subjects had abnormal tonometry at rest; all had supernormal values at peak exercise. The PCO 2 gradient correlated with clinical and gastroscopic severity; in patients reexamined after revascularisation (n=3), exercise tonometry returned to normal. Conclusion-Gastric tonometry during exercise is a promising non-invasive tool for diagnosing and grading gastrointestinal ischaemia and evaluating the results of revascularisation surgery for symptomatic gastric ischaemia.

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“…The comparative rarity of ischaemic lesions in spite of the relatively common finding of such vascular pathology at necropsy speaks highly for the rich anastomotic network of vessels supplying the intestine. The correlation between ischaemia of the gut of this zonal type and arterial disease is not always good (Dick, Graff, McGregg, Peters, and Sarner, 1967) and the position is clearly analogous to coronary artery disease and myocardial lesions. Single vessel thrombosis in an otherwise healthy coronary circulation produces infarction in some cases whereas widespread atheroma in others is associated with a relatively normal muscle.…”

Section: Discussionmentioning

confidence: 99%

Ischaemic enterocolitis: an expression of the intravascular coagulation syndrome

Whitehead¹

1971

Gut

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SUMMARY In 20 cases of ischaemic enterocolitis unassociated with lesions of major vessels, fresh thrombi were found in the small vessels of the bowel wall and were widespread in other tissues. The capillaries of the renal glomeruli and vessels in the lung were the commonest sites. Pseudo-membranous enterocolitis is shown to be an early or more slowly evolving but identical entity to other forms of so-called ischaemic enterocolitis. This is a condition which includes ischaemic enterocolitis, postoperative enterocolitis, necrotizing enterocolitis, and probably some cases of clostridial and staphylococcal enterocolitis. It is due to an episode of intravascular coagulation occurring principally in the gut wall but also elsewhere.

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An arteriographic study of mesenteric arterial disease. I. Large vessel changes.

Cited by 38 publications

References 23 publications

Experience with Coeliac Axis Compression Syndrome

Experience with Coeliac Axis Compression Syndrome

Increased gastric Pco ₂ during exercise is indicative of gastric ischaemia: a tonometric study

Ischaemic enterocolitis: an expression of the intravascular coagulation syndrome

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An arteriographic study of mesenteric arterial disease. I. Large vessel changes.

Cited by 38 publications

References 23 publications

Experience with Coeliac Axis Compression Syndrome

Experience with Coeliac Axis Compression Syndrome

Increased gastric Pco 2 during exercise is indicative of gastric ischaemia: a tonometric study

Ischaemic enterocolitis: an expression of the intravascular coagulation syndrome

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Product

Resources

About

Increased gastric Pco ₂ during exercise is indicative of gastric ischaemia: a tonometric study