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Query: UMLS:C0000727 (acute abdomen)
 3,084 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute mesenteric ischemia is an abdominal emergency due to inadequate tissue perfusion with a mortality rate between 60 and 100%. Intestinal damage by ischemia depends on general circulation, collateral blood flow, response of the mesenteric vasculature to autonomic stimuli, circulating vasoactive substances, local humoral factors, and the normal and abnormal products of cellular metabolism before and after reperfusion of the ischemic segment. Four physiopathologic phenomenon are present: superior mesenteric artery embolism; superior mesenteric artery thrombosis; non-occlusive acute mesenteric ischemia, and superior mesenteric venous thrombosis; embolism event is the most frequent. The injury observed after 3 of ischemia (blood flow reduced to 20% of normal) and 1 of reperfusion is more severe than 4 of ischemia. Clinical diagnosis of mesenteric ischemia required a high suspect index, specially in elderly patients with cardiovascular problems. Abdominal pain and hemodynamic and/or metabolic changes are the most frequent symptoms. Although some authors have questioned the need for angiography, this study is the key not only to making a diagnosis of acute mesenteric ischemia before bowel infarction and prior to laparotomy, but also to initiate intra-arterial mesenteric angiography therapy with vasodilators. Patients who persist with acute abdomen will require exploratory celiotomy and vascular exploration. The outcome depends on early diagnosis and therapy to avoid ischemia progression and reperfusion injury.
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PMID:[Acute mesenteric ischemia. Profile of an aggressive disease]. 1146 7

Acute vascular abdomen presents an incidence of 1% of all cases of acute abdomen, but the mortality rate is high, ranging from 50 to 80%. Acute mesenteric ischaemia and rupture of abdominal aorta aneurysms are the most frequent causes. Prevention of causal agents and early diagnosis are the only elements capable of improving patient survival. The authors report their personal experience over the period from 1996 to June 2002, analysing different clinical cases of acute vascular abdomen and their diagnostic and therapeutic management and comparing their experience with the relevant literature data.
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PMID:[Acute vascular abdomen: personal experience and review of the literature]. 1263 37

Acute mesenteric ischemia continues to be a highly morbid diagnosis with a high mortality rate. Percutaneous management of mesenteric ischemia is being more widely applied. Its utility is limited, though, for patients who present with an acute abdomen from ischemic bowel. The authors report a novel combination of open and endovascular techniques via a retrograde superior mesenteric artery (SMA) approach to treat acute mesenteric ischemia in the setting of an acute abdomen.
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PMID:Superior mesenteric artery angioplasty and stenting via a retrograde approach in a patient with bowel ischemia--a case report. 1476 Apr 83

Acute mesenteric ischemia (AMI) is a catastrophic disorder of the gastrointestinal tract with high mortality. Few data on the characteristics of this disease in Iran are available. Patient records of public and private hospitals in Shiraz, southern Iran, with impression of acute abdomen, bowel gangrene or abdominal pain, and patients with risk factors for this disease, who were admitted between March 1989 and March 2005, were reviewed. Among the 10,000 patient records studied, 105 patients (mean age 57 years) with AMI were identified. The mortality rate was 50.4%. The most common symptom was abdominal pain (98.1%). Heart diseases were seen in 44.7% of cases. The mortality rate was lower in patients undergoing mesenteric angiography (p=0.014). In those patients in whom the site of lesion was identified, venous thrombosis was the most common type (41.9%). AMI is a common cause of acute abdomen especially in elderly patients, with venous thrombosis being the most common type.
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PMID:Acute mesenteric ischemia: causes and mortality rates over sixteen years in southern Iran. 1940 57

Acute mesenteric ischemia is a serious acute abdominal condition requiring early diagnosis and intervention to improve the outcome. Although transmural acute bowel infarction represents about 1% of all cases of acute abdomen, it has a higher annual mortality rate than colon cancer. It tends to affect the colon in segmental fashion, mostly the splenic flexure and rectosigmoid portions of the colon. Isolated ischemia of the right side of the colon is rarely reported, especially in association with shock. Diagnosis of acute colonics ischemia is challenging as it may easily be confused with other non ischemic conditions both clinically and radiologically. Surgical resection is still the main curative approach. We present a case of segmental terminal ileum, cecum and part of ascending colon infarction due to isolated IleoColic artery thrombosis.
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PMID:Isolated ileocolic artery occlusion presented with segmental bowel infarction: a case report. 2006 70

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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PMID:A case report: an unsuspected case of acute mesenteric ischaemia. 2168 73

Acute mesenteric ischemia (AMI) is a rare cause of acute abdomen. Coupled with a high patient age, non-specific clinical symptoms and a significant co-morbidity the disease is still associated with a significant mortality of 60-85%. With a combination of preexisting cardiac arrhythmia and sudden abdominal pain AMI should always first be ruled out. Contrast-enhanced computed tomography (CT) scanning has replaced angiography as the first diagnostic step, largely because both intravascular and intra-abdominal pathologies can be diagnosed. In the case of an acute abdomen or lack of immediate access to diagnostic tools, rapid surgical exploration should be preferred. Surgical therapy includes embolectomy and resection of ischemic bowel segments. There should be a wide indication for second-look surgery. The most important prognostic factor and the only factor that can be influenced by the surgeon is the time interval between onset of symptoms and surgery. Therefore angiography or laparotomy should be performed as early as possible in cases of suspected AMI.
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PMID:[Acute mesenteric ischemia]. 2198 36

Acute mesenteric ischemia (AMI) is a life-threatening emergency with prognosis directly correlated with the delay in diagnosis and treatment. Clinical and laboratory findings are nonspecific and it is imperative to look for findings of AMI on CT and ultrasound examinations performed in patients with acute abdomen. Arterial and venous ischemia are different entities with different clinical and imaging features, treatment and prognosis. The main causes of AMI are arterial thromboembolic disease and low-flow state. Venous ischemia is less frequent. Due to its high reported sensitivity (90%), CT should be performed as a firstline imaging modality when AMI is suspected. CT and ultrasound imaging features of AMI include: bowel wall thickness and enhancement abnormalities, pneumatosis, portal venous gas, demonstration of intravascular thrombus, bowel dilatation and ascitis.
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PMID:[Acute mesenteric ischemia: Value of cross-sectional imaging]. 2215 38

Acute mesenteric ischemia (AMI) is a life threatening cause of acute abdomen. The purpose of this study is to define risk factors that predict the adverse outcome of AMI and to present our experience in the last 30 years. Hospital records and clinical data of 107 patients undergoing surgical intervention for AMI during the last 30 year period were reviewed and clinical outcomes as well as factors influencing mortality were analyzed. Mesenteric arterial thrombosis, arterial embolism and nonocclusive mesenteric ischemia (NOMI) were the cause of AMI in 68 (63.6%), 28 (26%), and 11 patients (10.2%), respectively. Abdominal pain was the most common presenting symptom (90.6%). Peritonitis was observed in 96 patients (89.7%) and 24 patients (22.4%) were in shock. Abdominal ultrasonography was performed in 46 patients (42%), abdominal CT angiography in 36 patients (33%) and mesenteric angiography in 12 patients (10.5%). All patients were operated and 11 (10%) patients underwent a second-look operation. Bowel resection was necessary in 101 patients (93.4%) during the initial operation and in seven patients (6.5%) during the second-look operation. The hospital mortality was 55.1%. Mortality was mainly due to multiorgan failure (43%). Diabetes mellitus, use of digoxine and antiplatelet drugs, duration of the symptoms until before surgery, existence of shock, low levels of the pH and bicarbonate and re-laparotomy were found to be negative predictors of the perioperative mortality. The use of total parenteral nutrition and CT angiography was found to be a protective factor against mortality. A high index of suspicion with prompt diagnostic evaluation with CT angiography may reduce time prior to surgical intervention which may lead to improved patient survival.
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PMID:A study on 107 patients with acute mesenteric ischemia over 30 years. 2288 39

Acute intestinal ischemia is an abdominal emergency occurring in nearly 1% of patients presenting with acute abdomen. The causes can be occlusive or non occlusive. Early diagnosis is important to improve survival rates. In most cases of late or missed diagnosis, the mortality rate from intestinal infarction is very high, with a reported value ranging from 60% to 90%. Multi-detector computed tomography (MDCT) is a fundamental imaging technique that must be promptly performed in all patients with suspected bowel ischemia. Thanks to the new dedicated reconstruction program, its diagnostic potential is much improved compared to the past and currently it is superior to that of any other noninvasive technique. The increased spatial and temporal resolution, high-quality multi-planar reconstructions, maximum intensity projections, vessel probe, surface-shaded volume rending and tissue transition projections make MDCT the gold standard for the diagnosis of intestinal ischemia, with reported sensitivity, specificity, positive and negative predictive values of 64%-93%, 92%-100%, 90%-100% and 94%-98%, respectively. MDCT contributes to appropriate treatment planning and provides important prognostic information thanks to its ability to define the nature and extent of the disease. The purpose of this review is to examine the diagnostic and prognostic role of MDCT in bowel ischemia with special regard to the state of art new reconstruction software.
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PMID:Multi-detector CT features of acute intestinal ischemia and their prognostic correlations. 2487 17


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