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Mesenteric Ischemia (mesenteric + ischemia)

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Medical Sciences	100%

Selected Abstracts

Time-dependent Variations in Ischemia-modified Albumin Levels in Mesenteric Ischemia

ACADEMIC EMERGENCY MEDICINE, Issue 6 2009
Abdulkadir Gunduz MD
Abstract Objectives:, The objective was to determine the value of ischemia-modified albumin (IMA) in the diagnosis of mesenteric embolism. The authors investigated whether or not plasma IMA levels rose in the acute period in a rat model of mesenteric ischemia and the related time-dependent changes. Methods:, In this randomized, controlled, nonblinded trial, 36 mature female Wistar rats were divided into six groups: three control (Groups I, III, and V) and three ischemia (Groups II, IV, and VI). In the control groups, blood was sampled at 30 minutes (Group I), 2 hours (Group III), and 6 hours (Group V) following a simple laparotomy. In the ischemia groups, following laparotomy, the superior mesenteric artery (SMA) was clamped using a bulldog clamp, and blood samples were taken at 30 minutes (Group II), 2 hours (Group IV), and 6 hours (Group VI). Results:, Plasma IMA levels in the ischemia groups were significantly higher compared to those of the control groups (p < 0.004). In addition, levels were higher in the 6-hour blood samples of the ischemia group than in the 2-hour and 30-minute samples (p < 0.001). Serum IMA was also higher in the 2-hour blood samples of the ischemia group than in the 30-minute samples (p < 0.001). Conclusions:, These preliminary findings suggest that serum IMA levels may represent a significant parameter in the early diagnosis of acute mesenteric ischemia and that further studies are necessary. [source]

Extravascular Transport of Fluorescently Labeled Albumins in the Rat Mesentery

MICROCIRCULATION, Issue 3 2002
NORMAN R. HARRIS
ABSTRACT Objective: Fluorescently labeled albumin is used frequently as a tracer when monitoring microvascular permeability. Several fluorescent dyes are available for labeling protein, including fluorescein isothiocyanate (FITC) and Texas Red (TR). Because differences in leakage of dye-labeled proteins have been reported, the objective of the present study was to compare the accumulation of these two tracers in interstitium and lymph after the inflammatory event of ischemiareperfusion. Methods: Anesthetized rats were injected intravenously with FITC-labeled albumin (FITC-alb) and TR-labeled albumin (TR-alb) before 30 minutes of mesenteric ischemia. Because the tracers leaked out of the microcirculation after reperfusion, accumulation in the surrounding buffer-superfused tissue, and in separate experiments, accumulation in lymph vessels, was defined as the ratio of tissue-to-plasma and lymph-to-plasma fluorescence. Results: Reperfusion induced a significant increase in tissue-to-plasma fluorescence of FITC-alb; however, no increase was observed for TR-alb. In contrast, lymph-to-plasma fluorescence of TR-alb tended to be greater than FITC-alb. Reperfusion-induced increases in tissue-to-plasma fluorescence of TR-alb occurred only when the superfusate was replaced with mineral oil, in which case tissue-to-plasma TR-alb fluorescence tended to be greater than FITC-alb. Conclusions: Measurement of fluorescently labeled albumin leakage from mesenteric venules depends on the dye used to label the albumin and requires an assessment of losses from the extravascular measuring region. [source]

Catastrophic multiple organ ischemia due to an anti-Pr cold agglutinin developing in a patient with mixed cryoglobulinemia after treatment with rituximab,

AMERICAN JOURNAL OF HEMATOLOGY, Issue 2 2009
Joshua Ruch
Cold agglutinin disease occurring with cryoglobulinemia is a rare occurrence. Here, we report a patient with mixed cryoglobulinemia that was treated with rituximab and, after response, developed an anti-Pr cold agglutinin that manifested with hemolysis and microvascular occlusion causing mesenteric ischemia and cerebral infarction. Unlike previous reports of patients with cryoglobulinemia and cold agglutinin disease, our patient did not have a detectable cryoprecipitate when his cold agglutinin manifested. Am. J. Hematol, 2009. © 2008 Wiley-Liss, Inc. [source]

Time-dependent Variations in Ischemia-modified Albumin Levels in Mesenteric Ischemia

Recalcitrant in-stent restenosis of the celiac trunk treated by drug-eluting stent

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 6 2008
Gabriella Visconti MD
Abstract Stent implantation is an alternative, safe, and reliable strategy for the treatment of chronic mesenteric ischemia, especially for patients at high surgical risk. However, in-stent restenosis (the Achille's hill of bare metal stent) may occur in up to 20% of cases at 6 months and 53% at 1 year. We describe a case of celiac trunk stenosis treated by bare metal stent complicated by recalcitrant in-stent restenosis and treated by paclitaxel-eluting stent implantation. © 2008 Wiley-Liss, Inc. [source]

6 The AERIS Course: a Focused Abdominal CT Interpretation Course for Abdominal Emergencies Requiring Immediate Surgery

ACADEMIC EMERGENCY MEDICINE, Issue 2008
Eric Schultz
Emergency physicians rely heavily on CT scanning to guide their clinical decisions. A significant number of EDs do not have radiology coverage, especially at night, so the EM physician may be called on to interpret their own CT scans to guide patient management. Many EM physicians look at their CT scans but have never had any formal training. Especially in the setting of acute surgical emergencies such as expanding abdominal aortic aneurysms (AAAs), ruptured spleen or perforated viscus, delay for a radiologist interpretation may result in significant morbidity and mortality. In a collaboration between emergency medicine and radiology, our team created a systematic approach to abdominal CT interpretation designed to help EM physicians perform wet reads on CT scans in the setting of acute surgical emergencies. First, a general survey is done covering all of the important organs such as the aorta, liver, spleen, kidneys, pancreas, stomach and bowel, then a focused scan into the suspected pathology. We put this system onto a Power Point presentation. The two hour presentation covered basic CT anatomic pathology then taught the presentations of common surgical emergencies such as appendicitis, nephrolithiasis and surgical catastrophes such as ruptured AAAs and mesenteric ischemia. The Abdominal Emergencies Requiring Immediate Surgery (AERIS) scan is only intended to be a focused scan for acute surgical pathology, and not to replace the diagnostic scan of a radiologist. This course was given at a single University program, and will be given at residency programs throughout the New York metro area. Eventually we hope that focused CT interpretation will become part of the standardized EM curriculum. [source]

Percutaneous Intervention of Superior Mesenteric Artery Stenosis in Elderly Patients

CLINICAL CARDIOLOGY, Issue 5 2009
Neelima Penugonda MD
This review article focuses on stent placement in mesenteric arteries in older patients with an increasingly common diagnosis of chronic mesenteric ischemia (CMI). We reviewed the articles that focused on the treatment of this gastrointestinal disorder by stenting/open surgical revascularization to avoid further ischemic episodes and bowel infarction and necrosis. The advantages of stent placement in mesenteric arteries are discussed in comparison to open surgical revascularization. In summary, the low morbidity and high technical success rate of catheter-based techniques have made this approach the first line of therapy for CMI due to superior mesenteric artery stenosis for many elderly patients especially high-risk operative candidates. Copyright © 2009 Wiley Periodicals, Inc. [source]