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

The technique described uses a composite prosthesis to combine infrarenal aortic resection with aorto-bifemoral bypass while preserving pelvic circulation. Its short-term objective is to prevent colic ischemia and its long-term objective to avoid impotence and gluteal claudication. This technique has the advantages of being simple, rapid and less aggressive than other procedures. It was applied in 6 cases over the last 2 years and was successful in all of them.
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PMID:[Composite arterial prosthesis for aortofemoral reconstruction with preservation of hypogastric flow]. 315 7

Despite clinical signs compatible with obstruction or ischemia of the gastrointestinal tract, the clinician occasionally is unable to identify a gastrointestinal cause for colic. In this article, disorders not originating from obstruction or ischemia of the gastrointestinal tract but causing real or apparent abdominal pain are presented as alternative causes of colic. In addition, colic of gastrointestinal origin may be the primary inciting factor or a secondary complication of an alternative disorder, causing colic-like signs. Recognition of alternative diagnoses relies on a thorough and consistent approach to the clinical assessment of the equine colic patient and helps to ensure appropriate patient management.
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PMID:Alternative diagnoses in the colic patient. 328 94

Clinical pathology is a valuable adjunct to physical examination of cases of colic. The present review considers evaluation of cases of colic for three main purposes: (1) making a prognosis, (2) deciding whether to operate, and (3) making a diagnosis. Blood tests noted to be useful for prognostication were hematocrit, lactate and urea nitrogen concentrations, pH, anion gap, fibrin/fibrinogen degradation products, antithrombin III activity, prothrombin time, and thrombin time. Horses with a poor prognosis often have relative polycythemia, marked lactic acidosis, high anion gap, azotemia, and coagulation abnormalities evidenced by increased fibrin/fibrinogen degradation products, decreased antithrombin III activity, and prolonged prothrombin and thrombin times. The decision to operate is usually a clinical one, supported by relative polycythemia, hyperglycemia, and, possibly, abnormal peritoneal fluid analysis. Diagnosis of the primary problem (causing the colicky signs) is also often based largely on physical examination. However, peritoneal fluid analysis provides worthwhile data, especially in cases of peritonitis or intestinal ischemia and infarction.
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PMID:Use of clinical pathology in evaluation of horses with colic. 332 25

Thirty horses were admitted to the University of Georgia Veterinary Medical Teaching Hospital with colic severe enough to warrant surgery and/or euthanasia. Gastrointestinal tracts of these 30 horses were histologically examined for morphologic changes. The horses were grouped according to cause of the colic (ie, simple obstruction, strangulation obstruction, thromboemboli, and inflammation). Lesions were graded as to severity, and grade scores were correlated with survival or nonsurvival. Mucosal changes developed distal and proximal to the primary lesion site and, although there were some differences between groups, changes characteristic of ischemia were common to all groups. The predictability of lesion grades of 2 or higher for nonsurvivability (90%) indicates that intestinal biopsy may have prognostic value in the postsurgical evaluation and management of equine colic.
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PMID:Histologic findings in the gastrointestinal tract of horses with colic. 396 60

In 25 years, from 1959 to 1984, esophageal substitution was performed in 32 patients. In most, the transverse colon was used, brought through the left chest on a vascular pedicle of the left colic artery. Indications for operation included: 21, esophageal atresia; 5, caustic injury; 3, peptic stricture; 2, esophageal varices with previous splenectomy; and 1, cartilagenous hamartoma of the esophagus. Six patients had failed prior reconstructions (1, gastric tube; 2, intrathoracic stomach; 1, presternal jejunum; 1, sloughed colon segment, 1, extensive stricture after primary repair). There was one postoperative death from fluid overload early in the series. Two patients had a localized leak at the upper anastomosis in the neck; neither resulted in stricture. One patient had a side leak in the lower intrathoracic colon, probably from an anchoring suture placed too deeply. Most patients had pyloroplasty with their operation. Four who did not required one later. Four patients required late reoperation for redundancy of the lower colon segment which emptied poorly; one lower colon was revised for stricture from exstrinsic compression at the substernal hiatus and another one for an inflammatory pseudopolyp with bleeding. There was no loss of a colon segment from ischemia. There is follow-up on all but one patient. Nineteen are more than ten years postoperative (mean of 18 years). Growth was assessed in that group. In atresia patients growth correlated with weight preoperatively and the presence or absence of associated anomalies. In the others growth was excellent in all but one patient. In our experience the colon conduit provides an excellent substitute esophagus for pediatric patients. The operation should have relatively low rate of major complications, most of which are avoidable, and most of which can be corrected to give a satisfactory long-term result.
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PMID:Colon interposition for esophagus in children. 408 10

115 of infra renal abdominal aorta have been operated upon between 1969 and 1984. 107 male patients (93%) and 8 female (7%) were treated. Age was 65.5. Associated high blood pressure was found in 43%, smoking in 74% and coronary disease in 20.5%. Non ruptured aneurysms were 84 (73%) and diagnosis was made chiefly in ischemia of lower limbs, ruptured were 31 (27%). 4 fistulas between aorta and lower vena cava were found at surgery. Aortograms have not been done in every case, even for non ruptured aneurysms, as 19 patients have been operated without (22.6% of non ruptured aneurysms). Ultrasonography have been done in 37. Among 84 patients with non ruptured aneurysm, 6 were not operated, 2 got only palliative surgery for rest pain, and 76 (85.7%) underwent resection and grafting. 31 patients were operated when ruptured. Post operative mortality for non ruptured aneurysms was of 2 (2.63%) for resection and grafting. It was of 24 (77.4%) if ruptured. Follow-up study shows that at a five years range 62.7% of surviving operated patients are alive. Authors point out that lower limbs ischemia is still often a revealing symptom. Post operative colic ischemia is rare.
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PMID:[Aneurysms of the subrenal abdominal aorta. Apropos of 115 cases]. 409 17

The progressive changes in colonic flora and the pattern of bacterial invasion of extracolonic sites were studied in a canine ischemic colon preparation. After 72 hours of colonic ischemia produced by ligation of the common colic and caudal mesenteric arteries, the total number of anaerobic organisms increased, with a concomitant decrease in aerobic organisms within the colon lumen. After 24 hours of ischemia, anaerobic bacteria only appeared in the portal vein and persisted. Aortic blood and peritoneal fluid cultures became positive after 48 hours with the same organisms. Polymicrobial intra-abdominal abscess and systemic Escherichia coli bacteremia occurred only in one animal with necrotic colonic disruption. Acute colonic ischemia promotes an overgrowth of intraluminal anaerobic bacteria, which penetrate the mucosal barrier and progressively invade the portal vein and, later, the systemic circulation.
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PMID:Early portal anaerobic bacteremia in mesenteric ischemia. 669 11

According to standard practice, the inferior mesenteric artery, when sacrificed, should always be ligated at its origin, proximal to the left colic branch. However, it should not be sacrificed and ligated but instead, be reimplanted if any doubt exists regarding the adequacy of the collateral circulation. The patient is in a high risk category for development of ischemia of the colon if there is an occlusion or absence of the marginal artery at the splenic flexure; absence of the middle colic artery; occlusion of one or both hypogastric arteries, or enlargement of the left colic artery, suggesting occlusion of the superior mesenteric artery.
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PMID:An anatomic basis to prevent ischemia of the colon during operations upon the aorta. 724 79

To clarify the pathogenesis and endoscopic features of ischemic lesions of the colon, experimental ischemia was induced in dogs by arterial ligation, gelfoam injection, and clipping. In addition, clinical and endoscopic features of ischemic lesions in ischemic colitis cases in human were studied. In the experimental model, arterial ligation including marginal arteries frequently induced erosions in the large intestine, whereas ligation of the colic artery alone did not induce apparent mucosal lesions of the large intestine. Gelfoam injection to produce thrombi into caudal mesenteric artery or middle colic artery induced ulcers with a high rate of incidence and frequently accompanied by intestinal perforation. Temporal impairment of blood supply by arterial clipping produced erosion, but not ulcers. A high incidence of erosion was obtained in a group that underwent clipping for a prolonged period and a group of receiving Alosenn. Mucosal blood flow measured by the hydrogen gas clearance method was significantly decreased at 1 hr and 4 hr after gelfoam injection compared with those after arterial ligation. In human cases of ischemia following arterial surgery, endoscopic features were similar to those lesions of the experimental ischemia induced by gelfoam injection. These results suggest that thrombi in peripheral small arteries may play a major role in the pathogenesis of ischemic lesions of the large intestine.
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PMID:[Experimental and clinical studies on ischemic lesions of the large intestine]. 772 85

Middle colic artery aneurysms are very uncommon. A few cases of occlusion of superior mesenteric artery aneurysms without bowel ischemia are reported. We describe successful uncomplicated embolization of a ruptured middle colic artery aneurysm with a Gelfoam plug.
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PMID:Embolization of a ruptured middle colic artery aneurysm. 778 36


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