Diagnosis and management of intestinal ischaemic disorders

Sreenarasimhaiah, Jayaprakash

doi:10.1136/bmj.326.7403.1372

Cited by 150 publications

(118 citation statements)

References 31 publications

Supporting

Mentioning

103

Contrasting

Unclassified

Order By: Relevance

“…In addition, AMI can be characterized by an initial discrepancy between severe abdominal pain and minimal clinical findings. Moreover, many of the patients who develop AMI suffer from other severe medical conditions, such as peritonitis, ileus, pancreatitis and gastrointestinal bleeding at the same time, which make the symptoms less reliable (8,9). Due to the non-specific clinical symptoms and presentations, early diagnosis and intervention of AMI are remain very difficult.…”

Section: Discussionmentioning

confidence: 99%

Analysis of serum enzyme levels in a rabbit model of acute mesenteric ischemia

Zhang

2011

Mol Med Report

View full text Add to dashboard Cite

Abstract. Early diagnosis of acute mesenteric ischemia (AMI) remains very difficult, partly due to the fact that useful markers of early small bowel ischemia have not yet been identified. Thus, in this study, we aimed to evaluate the levels of serum intracellular enzymes in the tissues and organs in a controlled animal model of mesenteric intestinal ischemia. Forty-eight New Zealand rabbits were divided into 4 groups including the control, artery ligation, vein ligation, and both artery and vein ligation groups. Plasma samples were obtained at 0-, 1-, 3-, 6-and 9-h time-points and enzyme levels were determined. The bowel color and vitality were observed at the same time. The bowel showed an appearance of infarction after a period of ischemia in the animals. Six and 9 h after superior mesenteric artery ischemia, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels increased significantly. However, after 3 h of superior mesenteric venous (SMV) ligation, γ-glutamyl transpeptidase levels in the blood were considerably higher compared to the control group. Six hours after SMV ischemia, ALT, AST, alkaline phosphatase and lactate dehydrogenase levels were significantly elevated compared to those pre-ligation. Serum enzyme levels during intestinal ischemia are not able to provide sufficient information as regards the extent and reversibility of intestinal ischemia, although, they may be able to reflect the presence of injury.

show abstract

Section: Discussionmentioning

confidence: 99%

Analysis of serum enzyme levels in a rabbit model of acute mesenteric ischemia

Zhang

2011

Mol Med Report

View full text Add to dashboard Cite

show abstract

“…The vascular factors are related to systemic arteriosclerosis based on hypertension, diabetes mellitus, hyperlipidemia and thrombus, embolus, and vasculitis. It is also associated with hypovolemia, hypotension and the use of vasoconstricting drugs [1,3] . The bowel factors are colon spasm, constipation, fecal impaction and prior history of abdominal surgery [1,2] .…”

Section: Introductionmentioning

confidence: 99%

“…It is also associated with hypovolemia, hypotension and the use of vasoconstricting drugs [1,3] . The bowel factors are colon spasm, constipation, fecal impaction and prior history of abdominal surgery [1,2] . The well-known pathological findings are degeneration, deciduation, necrosis, regeneration of the epithelial layer, congestion, fibrin thrombus in blood capillaries, leukocyte invasion in the lamina propria and bleeding, edema, and exudates in the submucosal layer [4] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hypoxia-inducible factor 1 alpha and vascular endothelial growth factor overexpression in ischemic colitis

Okuda

Azuma²,

Ohtani³

et al. 2005

WJG

View full text Add to dashboard Cite

show abstract

“…No laboratory test is able to sufficiently rule in or rule out the diagnosis of mesenteric ischemia (Sreenarasimhaiah 2003). There are some laboratory tests, essential for diagnosis, which should be ordered: Prothrombin time activated partial thromboplastin time, complete blood cell count, chemistry studies.…”

Section: Diagnosismentioning

confidence: 99%

Mesenteric Ischemia: Still a Deadly Puzzle for the Medical Community

Stamatakos

Stefanaki

Mastrokalos

et al. 2008

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

The main goal of this article is to update etiology, epidemiology, diagnosis, treatment and outcome of the various causes of mesenteric ischemia in order to elucidate its labyrinthine clinical riddle, by reviewing the current English medical literature. Mesenteric ischemia is a quite uncommon disorder, observed in the emergency department. It is a lifethreatening vascular emergency that requires early diagnosis and intervention to restore mesenteric blood flow and to prevent bowel necrosis and patient death. Consequently, it is a vital diagnosis to make because of its high mortality rate and its thorny complications. The underlying causes vary, and the prognosis depends on the specific findings during clinical examination. Vague and nonspecific clinical findings and limitations of diagnostic studies make the diagnosis a significant challenge. The prognosis of acute mesenteric ischemia of any type is grave. The complications following this medical jigsaw puzzle are also severe. Patients in whom the diagnosis is missed until infarction occurs have a mortality rate of 90%. Even with good treatment, up to 50-80% of patients die. Survivors of extensive bowel resection face lifelong disability. Despite the progress in understanding the pathogenesis of mesenteric ischemia and the development of treatment modalities, the entity remains a diagnostic challenge for clinicians. Delay in diagnosis contributes to a high mortality rate. Early diagnosis and adequate treatment can improve the clinical outcome. Even if diagnostic modalities have improved since the first successful attempts to confront effectively this clinical entity, mesenteric ischemia still remains a lethal diagnostic enigma for the medical community.Mesenteric Ischemia; thrombosis; bowel infarction; atherosclerosis; mesenteric venous thrombosis; mesenteric thromboendarterectomy.Tohoku

show abstract

Diagnosis and management of intestinal ischaemic disorders

Cited by 150 publications

References 31 publications

Analysis of serum enzyme levels in a rabbit model of acute mesenteric ischemia

Analysis of serum enzyme levels in a rabbit model of acute mesenteric ischemia

Hypoxia-inducible factor 1 alpha and vascular endothelial growth factor overexpression in ischemic colitis

Mesenteric Ischemia: Still a Deadly Puzzle for the Medical Community

Contact Info

Product

Resources

About