Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bowel ischemia and infarction are diseases primarily of, but not confined to, the elderly. Insidiously developing bowel ischemia may mimic more common gastrointestinal disturbances, such as peptic ulcer disease or malignancy, and go undiagnosed for long periods. Bowel infarction is a catastrophic event: Mortality rates approach 90%. Chronic intestinal ischemia may precede infarction, or infarction may occur with no warning. Laboratory and radiologic studies have minimal value in diagnosis of these disorders. A high index of suspicion must be maintained in patients complaining of abdominal pain if these diagnoses are to be made promptly.
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PMID:Bowel ischemia and infarction. Chronic and acute causes of abdominal pain. 368 21

The authors analyze 41 cases of temporary intestinal ischemia (15) or frank infarction (26) reported in the literature among oral contraceptive users. Like women with other thromboembolic diseases, duration of pill use was not a factor: these women had been taking orals for 10 days to 10 years, mean 2.2 years. Reversible ischemia resolved in days or weeks after discontinuing oral contraceptives, with supportive treatment. The best diagnostic tool was barium contrast radiogaphy. Neither arteriography or colonoscopy were helpful. Lesions were continuous, narrow, spastic, often with "thumbprinting", sometimes with proximal dilation. Intestinal infarction, usually determined at laparotomy, was fatal in 31%. Resection was necessary for gangrenous, pale or edematous small or large intestine or both. Most often the superior mesenteric artery or vein were involved. 42% needed a second laparotomty. Only 2 women developed ischemia or necrosis after oral contraceptives had been discontinued: both had documented arterial occlusion in all 3 major vascular trunks. The physiological cause of oral contraceptive-related ischemia or infarction is controversial. Several mechanisms including blood clotting factors, lipoproteins, platelet activity are reviewed. The evidence for the pill being involved in these cases is the young age and lack of preexisting risk factors, and especially resolution of the condition on stopping the pill, in the affected women.
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PMID:Intestinal ischemia and infarction associated with oral contraceptives. 376 15

Bowel infarction is a cause of acute abdominal emergency with high associated morbidity and mortality. Prior to the advent of CT, specific diagnosis was made either by mesenteric angiography or by direct visualization at surgery. This article describes the CT detection of intravascular mesenteric gas as a reliable indication of bowel infarction. Other nonspecific findings associated with bowel infarction and ischemia are also discussed.
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PMID:CT detection of bowel infarction. 400 56

Bowel infarction can complicate acute aortic dissection (AAD); in that case early diagnosis, which decreases the high mortality, is often difficult. We report the case of one patient who underwent surgery for AAD and developed a colonic infarction, which was clinically manifest on the 4th postoperative day. However, bowel ischemia was suspected already 48 hours after surgery, on the basis of the suggestive CK pattern and the absence of myoglobin in plasma. Total CK activity reached the highest level only 48 hours after surgery (92,800 U/l); the peak was coincident with LDH, which increased proportionally less; CK-MM constituted 100% of total CK activity. The absence of myoglobin in plasma excluded the presence of rhabdomyolysis. We conclude that such laboratory findings suggest the occurrence of severe bowel ischemia.
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PMID:Creatine-kinase isoenzyme pattern in colonic infarction consequent to acute aortic dissection. A case report. 834 80

Intestinal infarction remains a devastating event despite improvements in clinical recognition as well as diagnostic and therapeutic modalities. Recent changes in the etiology of this disease have not been examined. A retrospective review of 121 consecutive patients over a 6-year period was undertaken. Twenty-three patients died without operation, and mortality in the remaining 98 patients was 50 per cent. The only significant predictor of mortality was an elevated serum lactate at the time of diagnosis. Thirty-one patients (26%) developed infarction while hospitalized for another disease process; excluding patients with obstruction as the etiology of infarction caused this number to rise to 39 per cent. Nonocclusive mesenteric infarction was the most common disease process. The increased incidence of nonocclusive mesenteric infarction is likely due to the development of intestinal ischemia in already systemically ill patients. Nearly half of all cases of intestinal infarction due to nonobstructive causes develop in already hospitalized patients. The development of unexplained acidosis in a postoperative or critically ill patient should prompt a search for a reversible cause of mesenteric ischemia. Intestinal infarction may represent another example of the multisystem organ failure syndrome.
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PMID:The changing face of mesenteric infarction. 965 69

Superior mesenteric vein thrombosis (SMVT) is an uncommon but important clinical entity that can induce ischemia or infarction of the small and large bowel. It is rare and accounts for 5-15% of mesenteric vascular occlusions. Bowel infarction due to SMVT can present as an acute abdominal disease, requiring urgent laparotomy with resection of the intestinal segment affected. However, the clinical diagnosis of this event remains difficult and invariably requires specific imaging investigations in order to be able to treat the condition as soon as possible. SMVT without bowel infarction can present as persistent, non-specific abdominal pain and nausea with minimal clinical signs, affecting young individuals without any known predisposing disorder, where laparotomy is not an urgent indication. We report a case of a young adult man with SMVT due to a hypercoagulable state (protein S deficiency), in whom an early diagnosis and appropriate anticoagulant treatment prevented any further extension of the thrombotic process and limited the hemorrhagic infarction of the ileum, which simply required a segmental resection.
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PMID:Spontaneous superior mesenteric vein thrombosis (SMVT) in primary protein S deficiency. A case report and review of the literature. 1083 45

Acute intestinal ischemia is a gastrointestinal emergency resulting from a sudden decrement in intestinal blood flow. It may occur as a consequence of mesenteric vascular occlusion and/or hypoperfusion and may involve the small intestine or colon. Bowel infarction, sepsis, and death may result, making prompt diagnosis and management imperative. Acute mesenteric ischemia generally stems from interruption of blood flow within the superior mesenteric artery or vein, and leads to small intestinal hypoperfusion and infarction. It carries with it a mortality rate of approximately 70%, but improved survival may be achieved as a result of early diagnostic consideration, undelayed angiography, and surgical intervention, when appropriate. Acute colonic ischemia occurs typically as a result of a transient mismatch between intestinal blood flow and the metabolic demands of the colon. Although infarction may occur, colonic ischemia is often a reversible condition with mortality rates considerably lower than those witnessed in acute mesenteric ischemia. This article reviews the pathophysiology, clinical features, diagnostic, and therapeutic options applicable to patients with acute intestinal ischemia.
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PMID:Acute intestinal ischemia and infarction. 1288 81

Superior mesenteric artery (SMA) dissection without aortic dissection is a rare condition, and its diagnosis is considered to be difficult. Intestinal infarction is a severe complication of the disease, which may require resection of the intestine. We present a case of isolated SMA dissection. A 53-year-old man experienced sudden pain in the abdomen while playing Japanese pinball and was admitted to our hospital due to acute abdominal symptoms of uncertain cause. Enhanced CT revealed a defect of the root of the SMA, while angiography and intravascular ultrasound findings showed dissection of the SMA wall. Conservative treatment was chosen at the time, while a part of the small intestine was eventually resected because of progressive ischemia. Although SMA dissection is a rare occurrence in cases with acute abdominal symptoms, awareness of the condition is important for differential diagnosis.
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PMID:Isolated Superior Mesenteric Artery Dissection with Small Intestine Ischemia. 2660 Jul 71