Acute mesenteric ischemia due to superior mesenteric artery embolism in a patient with permanent atrial fibrillation

Šimunić, Miroslav; Fabijanić, Damir; Perković, Nikola; Bogdanović, Zoran; Maras–Šimunić, Marina; Batinić, Tonči; Tonkić, Ante

doi:10.22514/sv51.042010.6

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…17 As a summary, it can be said that early diagnosis is indispensable for an effective treatment, being the only way to keep mortality rates low. [18][19][20]…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With in-Hospital Death in Patients with Acute Mesenteric Artery Ischemia

Élthes¹,

Cozlea

Török³

2018

Journal of Cardiovascular Emergencies

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Objective: The aim of the study was to assess the factors associated with increased mortality in patients with acute mesenteric ischemia, emphasizing the importance of an early diagnosis and a prompt surgical intervention in order to avoid lesion progression. Materials and method: A retrospective analytical study was conducted on a study population of 50 male and female patients with acute ischemia of the mesenteric arteries, aged between 36-92 years. Demographic and pathological history characteristics were assessed, together with presented symptoms, laboratory and CT findings, as well as surgical outcome and time-related aspects between presentation in the emergency department and time of surgery, as well as the hospitalization period until discharge or death. Results: Muscular defense (OR = 23.05) and shock (OR = 13.24) as symptoms were strongly associated with a poor prognosis, while elevated values of lactate dehydrogenase (p = 0.0440) and creatine kinase (p = 0.0025) were associated with higher death rates. The time elapsed during investigations in the emergency room was significantly higher in patients who deceased (p = 0.0023), similarly to the total time from the onset of symptoms to the beginning of surgery (p = 0.0032). Surgical outcomes showed that patients with segmental ischemia of the small bowel had significantly higher chances of survival (p <0.0001). Conclusion: Increased mortality rates in patients presenting in the emergency department for acute mesenteric ischemia were observed in patients with occlusion of the superior mesenteric artery, with higher levels of CK and LDH, as well as with longer periods of stay in the emergency department for diagnostic procedures until the commencement of the surgical intervention. Therefore, proper investigations in a timely manner followed by a specific and prompt surgical intervention may avoid unfavorable evolution of patients towards death.

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“…17 As a summary, it can be said that early diagnosis is indispensable for an effective treatment, being the only way to keep mortality rates low. [18][19][20]…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With in-Hospital Death in Patients with Acute Mesenteric Artery Ischemia

Élthes¹,

Cozlea

Török³

2018

Journal of Cardiovascular Emergencies

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The Superior Mesenteric Artery: From Syndrome in the Young to Vascular Atherosclerosis in the Old

Beita

Whayne

2019

CHAMC

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: This review is directed at increasing awareness of two diverse rare upper gastrointestinal problems that occur at opposite ends of the age spectrum and are difficult to diagnose and treat. The Superior Mesenteric Artery Syndrome (SMAS) likely involves a young patient, especially female, and is especially associated with rapid weight loss, resulting in relative strangulation of the duodenum by a narrowing of the angle between the Superior Mesenteric Artery (SMA) and the aorta. On the other hand, atherosclerosis of the SMA is associated most likely with postprandial upper intestinal ischemia and abdominal pain occurs in the elderly at high risk for cardiovascular (CV) disease. : Medical management of the SMAS in the young involves good alimentation and weight gain to overall increase the intestinal fat pad. Medical management of SMA atherosclerotic ischemia in the elderly is directed at marked lipid lowering with atherosclerotic plaque stabilization or even regression. : If needed, surgery for SMAS can be attempted laparoscopically with duodenojejunoscopy which is the most popular procedure but there are also more conservative possibilities that avoid division of the duodenum. In addition, sometimes direct vision is needed to successfully operate on SMAS. If surgery is needed for SMA atherosclerotic ischemia, it is usually attempted endoscopically with angioplasty and stent placement. : Most important, in the case of these two rare clinical entities, is that the clinician have a suspicion of their presence when indicated so that the young or old patient can be spared unnecessary suffering and return to good health in a timely fashion.

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Acute mesenteric ischemia due to superior mesenteric artery embolism in a patient with permanent atrial fibrillation

Abstract: Acute mesenteric ischemia (AMI) is an uncommon disorder with SIGNA VITAE 2010; 5(1): 40 -43

Cited by 2 publications

References 8 publications

Factors Associated With in-Hospital Death in Patients with Acute Mesenteric Artery Ischemia

Factors Associated With in-Hospital Death in Patients with Acute Mesenteric Artery Ischemia

The Superior Mesenteric Artery: From Syndrome in the Young to Vascular Atherosclerosis in the Old

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