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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intestinal stasis or ileus is a significant cause of mortality and morbidity in horses and has been attributed to a variety of causes, including loss of intrinsic or extrinsic electrical activity, incoordination of contractile activity from regional stimuli, and dissociation between electrical and mechanical activity. Proposed mechanisms include systemic shock, electrolyte disturbances, persistent luminal distention, ischemia, inflammation, peritonitis, endotoxemia, and anesthesia. Because the cause of ileus is likely multifactorial, a variety of pharmaceutics have been used to target specific causes. Prokinetics are defined as agents that facilitate or enhance the net movement of feed material down the length of the intestinal tract and do not simply produce an uncoordinated increase in local contractile activity. The primary objective of pharmaceutic intervention is to augment the pathways that stimulate motility or attenuate the inhibitory neurons that predominantly suppress activity. The objective of this article is to summarize the actions of prokinetic agents available and suggest clinical applications.
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PMID:Clinical application of prokinetics. 1474 Jul 66

Gastrointestinal complications are known to occur after open elective aortic aneurysm repair. This leads to increased morbidity, mortality, length of stay, and hospital costs. The authors hypothesize a change in the character and/or frequency of early postoperative gastrointestinal complications after endovascular aneurysm repair as compared to open abdominal aortic repair. This is a retrospective cohort study in which the medical records of 153 consecutive patients who underwent endovascular infrarenal aneurysm repair from November 1998 to August 2001 were reviewed for gastrointestinal complications. Of these 153 patients, 9 (5.9%) had postoperative gastrointestinal complications. Three patients (1.9%) underwent exploratory laparotomy for small bowel obstruction. One patient had had a right hemicolectomy for cancer 2 years before stent graft placement. This patient needed a partial small bowel resection. One patient had had a right hemicolectomy 4 months before stent graft placement; he had lysis of adhesions with no bowel resection. A third patient underwent operative repair of an incarcerated inguinal hernia. Six patients (3.9%) had paralytic ileus that was treated by nasogastric tube or observation resulting in an extended hospital length of stay. All cases of ileus resolved without any operative intervention. No patients in this series developed any intestinal ischemia, pancreatitis, cholecystitis, or gastrointestinal bleeding. After endovascular aneurysm repair, gastrointestinal complications such as ileus and postoperative small bowel obstruction are seen with a similar frequency as after open aortic repair. This occurs despite the absence of a laparotomy with mesenteric dissection and evisceration. In this series, these complications are associated with longer hospital length of stay but no increased mortality rate. No instances of colonic ischemia, pancreatitis, cholecystitis, or gastrointestinal bleeding were seen in this series.
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PMID:Gastrointestinal complications following infrarenal endovascular aneurysm repair. 1506 44

An ischemic intestinal affection is observed frequently, its diagnosis difficult, mortality is high. In the clinic there were followed 47 patients with an ischemic intestinal affection. In 24 of them the etiology of ischemia was mesenterial thrombosis, in 23--strangulational ileus. While the doubt in intestinal viability existed, relaparotomy was performed for its state estimation and in necrosis-resection with primary anastomosis conduction. Mortality was 2.1%. Application of such a tactic had permitted to reduce significantly the frequency of resection conduction while doubt in intestinal viability present as well as mortality--in intestinal necrosis.
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PMID:[Repeated intestinal exploration and multi-stage surgeries within the program of the treatment of segment necrosis and the small intestine ischemia]. 1515 43

The inflammatory response is an important determinant of outcome after major surgery. Perioperative excessive stimulation of the inflammatory and hemostatic systems plays a role in the development of postoperative ileus, ischemia-reperfusion syndromes (e.g. myocardial infarction), hypercoagulation syndromes (e.g. deep venous thrombosis) and pain; together, these represent a significant fraction of major postoperative disorders. Epidurally administered local anesthetics prevent or modulate many of these processes. Since local anesthetics show inflammatory modulating properties in vitro and in vivo, they might also prevent these postoperative inflammatory processes when administered intravenously. Clinical studies have shown that perioperative local anesthetic administration significantly reduces the incidence of thrombosis and postoperative pain, shortens postoperative ileus and decreases hospital stay. On this basis we hypothesize that continuous intravenous administration of local anesthetic perioperatively might prevent or reduce several postoperative disorders resulting from excessive stimulation of inflammatory and hemostatic systems, and thereby improve surgical outcome.
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PMID:The poor man's epidural: systemic local anesthetics for improving postoperative outcomes. 1528 53

In the case presented here, we have succeeded in describing the endoscopic findings of anticoagulant ileus and evaluated the degree of bleeding as well as ischemia through endoscopic observation. We have demonstrated that enteroscopy using the double-balloon method is a useful diagnostic tool in the evaluation of a patient suspected to have anticoagulant ileus.
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PMID:Direct observation with double-balloon enteroscopy of an intestinal intramural hematoma resulting in anticoagulant ileus. 1530 75

In this review, systematic search of literatures for acute pancreatitis and nutrition was performed. Eleven randomized controlled trials (RCT) were found. Eight of them are about parenteral or enteral nutrition, 2 are about immunomodulated nutrition, and one is nutritional method in postoperative period. None of these showed benefit of total parenteral nutrition. Moreover, enteral nutrition via nasojejunal tube after 1-2 days after onset or operation of acute pancreatitis showed safe and more effectiveness than parenteral nutrition even in severe cases. These results indicate no benefit of parenteral nutrition in mild to moderate pancreatitis. Early enteral nutrition via nasojejunal tube can be used even in severe cases without ileus or intestinal ischemia.
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PMID:[Nutritional therapy in acute pancreatitis]. 1555 92

Catastrophic antiphospholipid syndrome (CAPS) is a severe and rare variant of antiphospholipid syndrome (APS) characterized by acute multiorgan failure due to small vessel thrombi in patients with positive antiphospholipid antibodies. We report a fatal case of catastrophic antiphospholipid syndrome in a young woman with a history of polymyositis and Hodgkin lymphoma. The patient was admitted to hospital because of severe foot pain following several weeks of skin ulcerations. Doppler ultrasonography showed evidence of arterial ischemia of the both lower extremities. Despite anticoagulation, immunosuppression, plasmapheresis and antibiotic therapy, she developed cutaneous gangrene, retroperitoneal hematoma, ileus, and acute respiratory and renal failure that resulted in death. Autopsy showed multifocal vascular injury and microthrombi with associated hemorrhages and infarcts in multiple organs. The patient had normal levels of functional protein C and protein S and a normal level of plasma homocysteine. Tests for common thromophilic gene mutations including prothrombin 20210, factor V Leiden 1691, and methylene tetrahydrofolate reductase 677 were negative. To our knowledge, this is the first CAPS patient with molecular studies for genetic prothrombotic mutations. Our report showed that there was no association between the development of CAPS and inherited thromophilia.
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PMID:Catastrophic antiphospholipid syndrome: a rare cause of disseminated microvascular thrombotic injury - a case report with pathological and molecular correlative studies. 1574 23

We report about a 43-year old woman with relapsing polychondritis, admitted with progressive malaise, fatigue, anorexia and profound weight loss. Two years ago a nasal chondritis with characteristic changes of the nasal profil, scleritis, laryngitis and unspecific general symptoms (fever, fatigue, signs of a systemic inflammation) developed and relapsing polychondritis was diagnosed. The patient was treated initially with azathioprine followed by methotrexate in combination with ciclosporine and glucocorticoids. During the hospitalization her condition slowly worsened, and crampy abdominal pain developed subsequently with massive tenderness, rebound and guarding. The clinically presumed diagnosis of ileus and peritonitis was radiomorphologically confirmed with signs of enteric perforation and a laparatomy was performed. A complete occlusion of the A. mesenterica superior and stenosis of the truncus coeliacus were diagnosed followed by a revascularization with an aorto-mesenteric bypass and subsequent resection of the necrotic ischemic ileum. An association with various autoimmune disorders including vasculitic syndromes is well known for relapsing polychondritis. The case demonstrated a progressive mesenteric ischemia with the acute exacerbation caused by a vasculitic mesenterial occlusion. The unusual presentation should be considered in the differential diagnosis of uncommon abdominal symptoms during the course of relapsing polychondritis.
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PMID:[Acute mesenteric ischemia in a patient with relapsing polychondritis]. 1636 96

It has been reported that avoidance of recurrences after laparoscopic ventral hernia repair (LVHR) depends on using sutures to secure the mesh. We developed a successful sutureless LVHR. The "Double Crown" LVHR using ePTFE mesh (overlap, 23 cm) was done in 140 cases. Tacks were placed 1 cm apart at the edge of the mesh. A second crown of tacks was placed at the edge of the defect. Three conversions (2.14%) and five bowel perforations occurred intraoperatively (3.57%). Postoperative complications were prolonged ileus (two cases), hematoma (two cases), seroma requiring drainage (three cases), and reoperation in one case for mesh intolerance, three cases for bowel perforation, and one case for small bowel ischemia. The recurrence rate (mean follow-up of 40 months) was 2.14%. The Double Crown LVHR is a safe alternative to LVHR using sutures, with a similar recurrence rate, less pain, fewer incisions and infections, and a shorter operating time.
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PMID:Laparoscopic ventral hernia repair without sutures--double crown technique: our experience after 140 cases with a mean follow-up of 40 months. 1646 50

The authors analyze the structure of acute abdominal pain in the general surgeon "s practice. The article contains the results of an analysis of the frequency of various causes of pain, as well as a description of the most frequent causes of death in acute pancreatitis, cholecystitis, appendicitis, bleeding and perforative ulcer, ileus, strangulated hernia, and acute mesenterial ischemia.
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PMID:[The cause of acute abdominal pain]. 1675 16


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