Determination of Intestinal Viability by Doppler Ultrasound

Hobson, Robert W.; Wright, Creighton B.; O’Donnell, J. A.; Jamil, Zafar; Lamberth, Wade C.; Najem, Zia

doi:10.1001/archsurg.1979.01370260055008

Cited by 53 publications

(14 citation statements)

References 9 publications

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“…3,1997; accepted on Jan. 6,1998) paid to this disorder as it is usually associated with a poor prognosis. [1][2][3] To prevent ischemic colitis, various measures have been adopted to obtain an adequate reconstruction of the enteric circulation, including the use of an intraoperative ultrasonic Doppler examination of the vasa recta, 4 the measurement of the stump pressure of the inferior mesenteric artery, 5 the measurement of colonic tissue blood flow via a laser Doppler flowmeter, 6 and transrectal Doppler measurements. 7 On the other hand, unexpected colonic ischemia may be induced in the case of a ruptured abdominal aortic aneurysm or low postoperative cardiac output, or cases in which a satisfactory reconstruction of the circulation has become difficult due to extensive arteriosclerosis.…”

Section: Introductionmentioning

confidence: 99%

Beneficial Effects of Prostaglandin E 1 on Ischemic Colitis Following Surgery on the Abdominal Aorta

et al. 1998

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To determine the effects of prostaglandin E1 (PGE1) on the intestinal circulation, an experimental dog model of ischemic colitis following abdominal aortic reconstruction was made by ligating the inferior mesenteric artery (IMA) and the internal iliac artery, with the creation of a 50% stenosis in the superior mesenteric artery (SMA). The parameters of enteric ischemia included the blood flow of the SMA, the tissue blood flow in the small intestine and left colon, the mean stump pressure of the IMA (IMAP), and the IMAP/mean systemic blood pressure ratio. With the continuous infusion of 10 ng/kg per minute of PGE1 into the descending thoracic aorta, these values increased significantly on the seventh postoperative day compared with those on the day of operation. These results thus suggest that the continuous intraarterial infusion of PGE1 may reduce ischemic changes in the colon following abdominal aortic reconstruction.

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Section: Introductionmentioning

confidence: 99%

Beneficial Effects of Prostaglandin E 1 on Ischemic Colitis Following Surgery on the Abdominal Aorta

et al. 1998

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“…In 1978, Ernst et al 4 reported that the IMA can be ligated if the stump IMA/systemic pressure ratio exceeds 0.4. Hobson et al 5 recommended that the IMA should be ligated following confi rmation of suffi cient blood fl ow in the mesenteric arcade by Doppler ultrasound measurement.…”

Section: Discussionmentioning

confidence: 99%

Two cases of colonic necrosis following aortoiliac surgery due to coronary-induced cardiogenic shock

Saito

Shirota

Nakamura

et al. 2007

Gen Thorac Cardiovasc Surg

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We report two cases of abdominal aortic aneurysm in which the patent inferior mesenteric arteries were ligated. The patient in Case 1, with occlusion of the right coronary artery, developed sudden bradycardia during surgery, resulting in cardiac arrest. The patient was successfully resuscitated and the operation was completed. In Case 2, acute thrombotic obstruction occurred postoperatively in the stent previously implanted in the left anterior descending coronary artery. Although the thrombus was removed by aspiration, hypotension was sustained. In both cases, colonic necrosis extending from the descending colon to the rectum developed following cardiogenic shock. The affected portion of the colon was resected and a colostomy was constructed. The incidence of coronary arterial disease is high in patients with abdominal aortic aneurysm. The occurrence of cardiac complications is not rare, and may result in catastrophic consequences. Therefore the inferior mesenteric artery should be reimplanted, especially in patients with concomitant heart disease.

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“…This is determined by the IMA stump pressure or pulsation of the vasa recta as predictors of postoperative colonic ischemia. 3,4 We have never encountered a case of colonic ischemia after AAA repair with ligation of the IIA according to the index of the IMA stump pressure or audible Doppler arterial sounds at the vasa recta. Therefore, reconstruction of the IIA is not necessarily required in combination with AAA surgery.…”

Section: Discussionmentioning

confidence: 99%

The Fate of Small Aneurysms of the Internal Iliac Artery Following Proximal Ligation in Abdominal Aortic Aneurysm Repair

et al. 2000

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To assess the natural history of small internal iliac artery aneurysms (IIAA) measuring 2.0-3.0 cm in diameter, proximally ligated in association with abdominal aortic aneurysm (AAA) repair, we examined 9 of 12 patients who underwent this type of surgery. Postoperative computed tomography scanning demonstrated that three IIAAs were still patent and the other six were thrombosed. An increase in the maximum diameter from that at the time of surgery was seen in four IIAAs. One patient suffered serious complications in that a dilated IIAA caused right ureteral obstruction and subsequent hydronephrosis accompanied by unilateral renal dysfunction. This was successfully treated by resection of the IIAA. The findings of this analysis led us to conclude that small IIAAs associated with AAA repair should be treated by either endoaneurysmorrhaphy or resection of the aneurysm after both proximal and distal ligation.

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Determination of Intestinal Viability by Doppler Ultrasound

Cited by 53 publications

References 9 publications

Beneficial Effects of Prostaglandin E 1 on Ischemic Colitis Following Surgery on the Abdominal Aorta

Beneficial Effects of Prostaglandin E 1 on Ischemic Colitis Following Surgery on the Abdominal Aorta

Two cases of colonic necrosis following aortoiliac surgery due to coronary-induced cardiogenic shock

The Fate of Small Aneurysms of the Internal Iliac Artery Following Proximal Ligation in Abdominal Aortic Aneurysm Repair

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