Duplex ultrasonography in the diagnosis of celiac and mesenteric artery occlusive disease

Bowersox, Jon C.; Zwolak, Robert M.; Walsh, Daniel B.; Schneider, Joseph R.; Musson, Anne; LaBombard, F.Elizabeth; Cronenwett, Jack L.

doi:10.1067/mva.1991.33215

Cited by 139 publications

(77 citation statements)

References 13 publications

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“…Combining B-mode ultrasound and duplex sonography is a standard initial non-invasive method to visualize the aorta and larger splanchnic arteries. In addition, several functional parameters of splanchnic blood flow can be obtained [18]. Duplex sonography is not able to reliably evaluate small splanchnic vessels or measure small bowel mucosal perfusion.…”

Section: Sonographymentioning

confidence: 98%

Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy

et al. 2001

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Non-occlusive mesenteric ischemia (NOMI) compromises all forms of mesenteric ischemia with patent mesenteric arteries. It generally affects patients over 50 years of age suffering from myocardial infarction, congestive heart failure, aortic insufficiency, renal or hepatic disease and patients following cardiac surgery. Non-occlusive disease accounts for 20-30% of all cases of acute mesenteric ischemia with a mortality rate of the order of 50%. Acute abdominal pain may be the only early presenting symptom of mesenteric ischemia. Non-invasive imaging modalities, such as CT, MRI, and ultrasound, are able to evaluate the aorta and the origins of splanchnic arteries. Despite the technical evolution of those methods, selective angiography of mesenteric arteries is still the gold standard in diagnosing peripheral splanchnic vessel disease. In early non-occlusive mesenteric ischemia, as opposed to occlusive disease, there is no surgical therapy. It is known that mesenteric vasospasm persists even after correction of the precipitating event. Vasospasm frequently responds to direct intra-arterial vasodilator therapy, which is the only treatment that has been shown to be effective.

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Section: Sonographymentioning

confidence: 98%

Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy

et al. 2001

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“…A velocity > 275 cm/s is indicative of >70% stenosis with a sensitivity of 92% and a negative predictive value of 99% [41] . Doppler sonography is useful in diagnosing chronic mesenteric arterial occlusive disease but has limited role in AMI [42][43][44][45] . Other applications for duplex sonography are detection of reversible celiac flux alteration such as in median ligament syndrome, and follow-up of mesenteric bypass grafts and stents [41] .…”

Section: Imaging Studiesmentioning

confidence: 99%

Acute mesenteric ischemia after cardio-pulmonary bypass surgery

Abboud¹,

Daher²,

Boujaoude³

2008

WJG

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Acute mesenteric ischemia (AMI) is a highly-lethal surgical emergency. Several pathophysiologic events (arterial obstruction, venous thrombosis and diffuse vasospasm) lead to a sudden decrease in mesenteric blood flow. Ischemia/reperfusion syndrome of the intestine is responsible for systemic abnormalities, leading to multi-organ failure and death. Early diagnosis is difficult because the clinical presentation is subtle, and the biological and radiological diagnostic tools lack sensitivity and specificity. Therapeutic options vary from conservative resuscitation, medical treatment, endovascular techniques and surgical resection and revascularization. A high index of suspicion is required for diagnosis, and prompt treatment is the only hope of reducing the mortality rate. Studies are in progress to provide more accurate diagnostic tools for early diagnosis. AMI can complicate the post-operative course of patients following cardio-pulmonary bypass (CPB). Several factors contribute to the systemic hypo-perfusion state, which is the most frequent pathophysiologic event. In this particular setting, the clinical presentation of AMI can be misleading, while the laboratory and radiological diagnostic tests often produce inconclusive results. The management strategies are controversial, but early treatment is critical for saving lives. Based on the experience of our team, we consider prompt exploratory laparotomy, irrespective of the results of the diagnostic tests, is the only way to provide objective assessment and adequate treatment, leading to dramatic reduction in the mortality rate.

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“…[3][4][5] Doppler ultrasonography, spiral computed tomography, and mesenteric angiography are commonly used imaging modalities for diagnosing mesenteric ischemia. [6][7][8] These can be invasive, costly, viewer-dependent, and time-consuming. Leukocytosis, acidosis, elevated lactate, hyperphosphatemia, and elevated amylase are nonspecific laboratory markers that are sometimes used for this same purpose.…”

mentioning

confidence: 99%

The Diagnostic Value of Ischemia-modified Albumin in a Rat Model of Acute Mesenteric Ischemia

Uygun

Yılmaz

Pekdemir

et al. 2011

Academic Emergency Medicine

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Objectives: Previous studies have demonstrated that ischemia-modified albumin (IMA) is a useful marker for the diagnosis of ischemic events. This study aimed to determine the value of ischemia-modified plasma albumin in the early diagnosis of acute mesenteric ischemia in an experimental model. Methods:The study was performed on 32 Wistar albino rats divided into control (n = 8), sham (n = 8), 2-hour (n = 8), and 6-hour (n = 8) ischemia groups. Mesenteric ischemia was created by arterial occlusion, and then blood samples (2 mL) were collected and centrifuged. Serum levels of IMA were measured by a rapid calorimetric test that determined the reduced cobalt binding to albumin. For histopathologic evaluation, samples of the small intestine were obtained from the animals after they were euthanized at the end of the experiment.Results: Histopathologic damage of the intestinal wall correlated with the duration of ischemia. While the mean pathology scores of the 2-and 6-hour ischemia groups were different from each other, IMA levels (mean ± SD) in the four groups were not significantly different from each other: 0.55 ± 0.07 absorbance units (ABSU) in the control group, 0.62 ± 0.09 ABSU in the sham group, 0.60 ± 0.07 ABSU in the 2-hour ischemia group, and 0.64 ± 0.12 ABSU in the 6-hour ischemia group (p = 0.153). Conclusions:Serum IMA values were not useful in the early diagnosis of acute mesenteric ischemia. Further studies to investigate ischemic and nonischemic conditions that affect IMA levels are needed.

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Duplex ultrasonography in the diagnosis of celiac and mesenteric artery occlusive disease

Cited by 139 publications

References 13 publications

Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy

Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy

Acute mesenteric ischemia after cardio-pulmonary bypass surgery

The Diagnostic Value of Ischemia-modified Albumin in a Rat Model of Acute Mesenteric Ischemia

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