Idiopathic mesenteric venous thrombosis: Report of a case

Dobrinja, Chiara; Trevisan, Giusto; Petronio, B.; Liguori, Giovanni

doi:10.1016/j.jmv.2008.02.001

Cited by 4 publications

(5 citation statements)

References 29 publications

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“…Mesenteric venous thrombosis accounts for approximately 10% of all AMI cases [2] and involves the superior mesenteric vein in over 90% of patients. Mesenteric venous thrombosis is usually secondary to an underlying coagulopathy, while in 10% the cause is idiopathic [11][12][13][14][15] . Patients should be screened for genetic thrombophilias.…”

Section: Pathophysiologymentioning

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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Section: Pathophysiologymentioning

confidence: 99%

Acute mesenteric ischemia after cardio-pulmonary bypass surgery

Abboud¹,

Daher²,

Boujaoude³

2008

WJG

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“…Other blood markers such as WCC and CRP eventually returned to normal once he recovered from surgery. Dobrinja C et al and Choudhary et al have previously described cases of idiopathic mesenteric venous thrombosis, one of which was treated successfully with bowel resection and anticoagulation 3 , 4. It is important to note that a delay in diagnosis is often reported in such cases.…”

Section: Discussionmentioning

confidence: 99%

A case report: an unsuspected case of acute mesenteric ischaemia

Matharu

Khalid²,

Ho³

et al. 2009

Case Reports

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Acute mesenteric ischaemia is a severe surgical condition with significant mortality, and it requires prompt recognition and surgical intervention. This report describes a case of a middle-aged gentleman with no previous risk factors who presented with an acute abdomen secondary to mesenteric ischaemia and made a full recovery. This case illustrates that mesenteric ischaemia can occur without the presence of any obvious risk factors and if treated early can result in successful outcomes.

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“…Dažniausiai aptinkama v. mesenterica superior. Ši priežastis yra antrinės kilmės ir gali būti sąlygota sutrikusios koaguliacijos, nors gali būti ir idiopatinės kilmės [1,2,7].…”

Section: įVadasunclassified

Ūminė mezenterinė išemija po širdies operacijos

Andrejaitienė¹

2010

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Judita Andrejaitienė Kauno medicinos universiteto Biomedicininių tyrimų institutas, Intensyviosios terapijos ir kraujotakos tyrimų laboratorija, KMU BMTI Intensyviosios terapijos ir kraujotakos tyrimo laboratorija, Eivenių g. 4, LT-50009 KaunasEl. paštas: andrejaitiene@yahoo.com Ūminė mezenterinė išemija po širdies operacijų yra retai pasitaikanti, tačiau gyvybei grėsminga kraujagyslių patologija, apibūdinama kaip staigus simptominis žarnyno kraujotakos sutrikimas (sulėtėjimas arba nutrūkimas), galintis sukelti žarnyno infarktą. Šios patologijos išeitys priklauso nuo ligos trukmės, t. y., kiek laiko praeina nuo ligos nustatymo iki gydymo, diagnostika – ypač sunki ir dažnai užtrunka dėl nespecifinių laboratorinių bei radiologinių tyrimų rezultatų. Gal todėl užmirštama apie šios (dažniausiai letalios baigties) ligos simptomus. Kai ūminė mezenterinė išemija įvyksta ankstyvuoju pooperaciniu laikotarpiu ligoniams po širdies operacijų naudojant dirbtinę kraujo apytaką, šių ligonių būklė yra labai sudėtinga dėl klastingo klinikinio pasireiškimo, ypač sunkios diagnostikos bei gydymo ir tai sąlygoja didelį pooperacinį mirštamumą. Šio atvejo pristatymu ir literatūros apžvalga siekiama atkreipti kolegų dėmesį į galimas pooperacines komplikacijas ligoniams po širdies operacijų, pateikiama ūminės mezenterinės išemijos patofiziologinių mechanizmų samprata, diagnostikos testai, taip pat siekiama pabrėžti, kokia sudėtinga diferencinė diagnostika ir koks didelis mirštamumas, priminti gydymo pasirinkimo galimybes ir atverti perspektyvias tyrimo sritis. Reikšminiai žodžiai: širdies operacija, dirbtinė kraujo apytaka, hipoperfuzija, ūminė mezenterinė išemija, neokliuzinė mezenterinė išemija, mezenterinė trombozė. Acute mesenteric ischemia following cardiac surgery Judita Andrejaitienė Institute for Biomedical Research Kaunas University of Medicine, Laboratory of Intensive Care and Blood Circulation Research, Eivenių str. 4, LT-50009 Kaunas, LithuaniaE-mail: andrejaitiene@yahoo.com Acute mesenteric ischemia is a highly-lethal surgical emergency in which the outcome is closely dependent on the elapsed time to diagnosis and treatment. The diagnosis is typically difficult and delayed due to nonspecific results of biological and radiological tests. Since prompt treatment is the key to a better outcome, acute mesenteric ischemia remains a challenging condition because of controversial algorithms and numerous therapeutic options. Acute mesenteric ischemia can complicate the post-operative course of patients following cardiopulmonary bypass (CPB). Several factors contribute to the systemic hypo-perfusion state, which is the most frequent pathophysiologic event. The condition has a more subtle clinical presentation, is more difficult to diagnose and treat, leading to a higher mortality rate. This report is an updated review of acute mesenteric ischemia in CPB with respect to the pathophysiologic events, diagnostic tests, therapeutic options, mortality rate and promising new areas of research. Keywords: cardiac surgery, cardiopulmonary bypass, hypoperfusion, acute mesenteric ischemia, non-occlusive mesenteric ischemia, mesenteric thrombosis.

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Idiopathic mesenteric venous thrombosis: Report of a case

Cited by 4 publications

References 29 publications

Acute mesenteric ischemia after cardio-pulmonary bypass surgery

Acute mesenteric ischemia after cardio-pulmonary bypass surgery

A case report: an unsuspected case of acute mesenteric ischaemia

Ūminė mezenterinė išemija po širdies operacijos

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