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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two patients with atrial fibrillation had abrupt onset of abdominal pain and massive small bowel distension suggesting mesenterial artery embolism. One patient had dilation of the left atrium and ventricle, the other a mitral value prolapse syndrome with a dilated left atrium. Both patients were treated conservatively and gradually recovered. A small bowel series performed several weeks after the acute episode showed loss of normal mucosa and narrowing of a long segment of the small bowel. A control examination in one patient one year later, still revealed jejunal mucosal abnormalities and stenosis, features similar to those occurring in Crohn's disease. Our observations suggest that analogous to ischemic colitis, an entity of acute ischemic small bowel enteritis exists. Mesenteric ischemia apparently can induce a clinical syndrome of "regional enteritis". The radiologic features should not be confused with those of Crohn's disease.
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PMID:Acute small bowel ischemia without transmural infarction. 195 43

Mesenteric ischemia associated with carcinoid tumors often presents with nonspecific abdominal pain and is usually due to mesenteric branch artery occlusion caused by elastic vascular sclerosis. Mesenteric ischemia was defined by the operative findings of cyanosis or infarction. Eleven patients with intraabdominal metastatic carcinoid tumor were evaluated by angiography. Angiographic narrowing and occlusion of multiple peripheral jejunal and ileal intramesenteric branch arteries was present in 3 patients with mesenteric ischemia, but also occurred in 5 of 8 patients without mesenteric ischemia. Other angiographic abnormalities included staining of the primary tumor (5) or metastases (6), tenting of small mesenteric vessels (5), and occlusion of draining mesenteric veins (2). We conclude that in patients with midgut carcinoid tumors, angiographic narrowing and occlusion of peripheral mesenteric arteries most likely represents elastic vascular sclerosis, is indicative of mesenteric invasion of tumor, but correlates poorly with the presence of ischemia in the subtended bowel. Alternatively, a normal selective arteriogram should exclude mesenteric ischemia as the cause of abnormal pain.
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PMID:Limitations of angiography for mesenteric ischemia caused by midgut carcinoid tumors. 250 47

Gastrointestinal and liver disorders are often observed in high performance athletes, especially those training for the increasingly popular endurance sports including the marathon and the triathlon. The disorders often start with stress before competition or training, followed by dehydration during the event. Insufficient training is an aggravating factor as are certain environmental factors including hot climate, irregular terrain and high altitude. Athletes may also consume non-steroid anti-inflammatory drugs, for example after a minor bone lesion or joint sprain, in an attempt to maintain their highest level of performance. Gastric signs include epigastric pain known to be caused by ischaemic gastritis resulting from decreased splanchnic flow and increased vasoconstriction in the gastric mucosa. Gastrooesophageal reflux results from modifications in sphincter tone and gastric emptying. Drinking hyperosmolar liquids also plays a role. Abdominal pain, diarrhoea, melena and uncommonly ischaemic colitis are the main signs of colic disorders. Mesenteric ischaemia may occur due to lowered splanchnic blood supply (by as much as 80% in some cases). Mechanical trauma is another mechanism; in marathon runners the "caecal slap syndrome" is a repeated microtrauma of the caecum against a hypertrophied muscular wall. Waterborne infectious agents may also lead to colic lesions. Exertion heat stroke is an emergency situation which can cause multiple organ damage and usually occurs after long intense exercise, often, but not always in a hot environment. Uncompensated thermogenesis and excessive loss of water by perspiration leads to central hyperthermia and ischaemic hepatic necrosis. Fatal liver failure has been observed. More or less severe symptoms of gastrointestinal or hepatic disorders are observed in 30% of high performance athletes and the incidence may reach 40% in those who have trained insufficiently. Such disorders lead to reduced performance in 10% of these athletes.
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PMID:[Hepato-digestive disorders in athletic practice]. 802 25

Mesenteric ischemia usually occurs in elderly patients, especially those with predisposing factors. It has also been described in young patients using oral contraceptive pills or illicit drugs. We present a case of a middle-aged woman who developed acute focal ischemia of the small intestine without predisposing factors. The unusual presentation of this patient, combined with her relative youth, obscured the diagnosis, which was ultimately made at laparotomy. The diagnosis of mesenteric ischemia should be considered in patients of any age presenting with recurrent or severe abdominal pain, particularly when no alternative cause is apparent. The definitive study to diagnose mesenteric ischemia is angiography. Unless identified early in its course, the condition may progress to frank infarction with a significant increase in morbidity and mortality. Because of this, an aggressive approach to the diagnosis and therapy of mesenteric ischemia is essential.
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PMID:Acute mesenteric ischemia in a middle-aged patient: case report and discussion. 874 45

Mesenteric ischaemia is a rare but serious cause of abdominal pain. We present the case of a man with Sneddon's syndrome, who had symptomatic mesenteric ischaemia secondary to a superior mesenteric artery stenosis in conjunction with a hepatic artery stenosis. As far as the authors are aware, this has not previously been described in Sneddon's syndrome, which is a vascular systemic disease characterized by an association between cerebrovascular accidents and a livedo reticularis skin rash. He was treated with balloon angioplasty and stent insertion, with good symptomatic improvement. This has implications for other stenoses in this condition should they become symptomatic.
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PMID:Superior mesenteric artery stenting for mesenteric ischaemia in Sneddon's syndrome. 1056 Mar 45

We report a 33-year-old man with distal ileum infarction after intravenous abuse of cocaine. He underwent resection of a gangrenous bowel segment and survived. We review the literature regarding intestinal ischaemia related to cocaine. To date, 19 cases have been published. Like most previously reported cases, our patient was young and had no previous history of arteriosclerosis. He suffered cocaine-induced rhabdomyolysis and acute renal failure. Mesenteric ischaemia should be considered in the differential diagnosis of acute or chronic abdominal pain in cocaine consumers.
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PMID:Cocaine-induced mesenteric ischaemia. 1115 17

Mesenteric ischemia is an important clinical condition becoming more prevalent with aging of the population. Mesenteric ischemia may be manifest in an acute presentation, usually secondary to thromboembolism or cardiac insufficiency. Patients have abdominal pain, lactic acidosis, benign abdominal examination, and, often, coexistent multisystem organ dysfunction. Chronic mesenteric ischemia is secondary to proximal arterial stenosis or occlusions inadequately compensated by collateral flow. Clinical presentation may simulate occult malignancy. In this review article, the role of Doppler sonography and other diagnostic imaging tests in suspected acute mesenteric ischemia and mesenteric arterial insufficiency are evaluated with emphasis on diagnostic criteria and appropriate use in each clinical context.
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PMID:Mesenteric ischemia. 1297 81

Mesenteric ischaemia results from decreased blood flow to the bowel, causing cellular injury from lack of oxygen and nutrients. Acute mesenteric ischaemia (AMI) is an uncommon disorder with high morbidity and mortality, but outcomes are improved with prompt recognition and aggressive treatment. Five subgroups of AMI have been identified, with superior mesenteric artery embolism (SMAE) the most common. Older age and cardiovascular disease are common risk factors for AMI, excepting acute mesenteric venous thrombosis (AMVT), which affects younger patients with hypercoaguable states. AMI is characterized by sudden onset of abdominal pain; a benign abdominal exam may be observed prior to bowel infarction. Conventional angiography and more recently, computed tomography angiography, are the cornerstones of diagnosis. Correction of predisposing conditions, volume resuscitation and antibiotic treatment are standard treatments for AMI, and surgery is mandated in the setting of peritoneal signs. Intra-arterial vasodilators are used routinely in the treatment of non-occlusive mesenteric ischaemia (NOMI) and also are advocated in the treatment of occlusive AMI to decrease associated vasospasm. Thrombolytics have been used on a limited basis to treat occlusive AMI. A variety of agents have been studied in animal models to treat reperfusion injury, which sometimes can be more harmful than ischaemic injury. Chronic mesenteric ischaemia (CMI) usually is caused by severe obstructive atherosclerotic disease of two or more splanchnic vessels, presents with post-prandial pain and weight loss, and is treated by either surgical revascularization or percutaneous angioplasty and stenting.
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PMID:Review article: diagnosis and management of mesenteric ischaemia with an emphasis on pharmacotherapy. 1569 Dec 94

Mesenteric ischemia is an uncommon etiology of abdominal pain. Celiac axis compression syndrome is an extremely rare cause of mesenteric ischemia. The primary pathological mechanism is the external compression of the celiac trunk by median arcuate ligament. The clinical manifestation of celiac axis compression syndrome includes postprandial pain, diarrhea, and body weight loss. The diagnosis of this disease is usually difficult and depends on the angiography findings. For treatment, only percutaneous transluminal angioplasty and surgical intervention have been suggested in reviews in the literature. We, herein, report an unusual case of celiac axis compression syndrome and also review the literature pertaining to this disease.
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PMID:A rare cause of mesenteric ischemia: celiac axis compression syndrome. 1767 67

Mesenteric ischemia among chronic dialysis patients is usually of the nonocclusive type. Chronic occlusive mesenteric ischemia has been reported rarely in the dialysis population. The subset of"celiac-territory ischemic syndrome" has not been described in dialysis. The current report involves a 66-year-old female on chronic dialysis for 11 years. She experienced abdominal pain following sessions of hemodialysis, that later became more pronounced after eating. Abdominal angiography showed heavily calcified aorta, celiac trunk and superior mesenteric artery (SMA), with a 50% narrowing of the celiac and superior mesenteric arteries. During the following 9 months the symptoms worsened and weight loss set in. She was admitted with an episode of upper abdominal pain. Acalculous cholecystitis was found, along with multiple gastric and duodenal erosions including the second part, with an antral ulcer and multiple duodenal bulb ulcers. Repeated abdominal angiography showed progression of the stenotic lesions with significant narrowing of both the celiac trunk and the SMA. A stent was placed in the SMA. Following the procedure, the patient noted marked symptomatic improvement. On follow-up gastroduodenoscopy, all ischemic ulcers had healed completely. Serum albumin rose from a nadir of 31 to 40 g/l, and an extremely elevated c-reactive protein of 205,000 microg/l returned to normal (8,000 microg/l). The diagnosis of chronic occlusive mesenteric ischemia should be suspected among dialysis patients with post-prandial pain and weight loss in the face of calcified vessels. Predominant celiac territory ischemic syndrome presents as gastric and duodenal erosions and ulcers with or without acalculous cholecystitis.
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PMID:Celiac territory ischemic syndrome in a patient on chronic hemodialysis. 1796 95


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