Outcomes and clinical characteristics of transmural intestinal necrosis in acute mesenteric ischemia

Wang, Xinyu; Chu, Chengnan; Sun, Shilong; Xie, Tian; Duan, Zhiwen; Wang, Kai; Bao-chen, Liu; Fan, Xinxin; Wu, Xingjiang; Ding, Weiwei

doi:10.1080/00365521.2019.1646800

Cited by 27 publications

(20 citation statements)

References 26 publications

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“…Our results also suggested that WBC count is associated with intestinal necrosis, indicating a promising potential of WBC count in predicting intestinal necrosis in patients with mesenteric ischemia. Interestingly, we did not observe a significant increase in lactate level in our study, which is inconsistent with other reports (18,20,21). This is probably attributable to the heterogeneity of patients and the limited number of patients admitted to a single center.…”

Section: Multivariate Analysis Of Risk Factors For Intestinal Necrosiscontrasting

confidence: 99%

Predictors and risk factors for intestinal necrosis in patients with mesenteric ischemia

Zhao¹,

Meng²,

Zhang³

et al. 2021

Ann Transl Med

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Background: Mesenteric ischemia results in blood flow that is insufficient to meet metabolic demands and subsequent dysfunction of visceral organs, including arterial obstruction and venous thrombosis. Sustained mesenteric ischemia exhausts the ability of capillaries to provide oxygen and initiate an inflammatory reaction, and eventually leads to intestinal mucosal necrosis, a serious and potentially life-threatening condition. Therefore, it is essential that the predictors and risk factors for intestinal necrosis in patients with mesenteric thrombus are explored.Methods: This study retrospectively enrolled 41 patients with mesenteric ischemia (including mesenteric vein embolism, mesenteric artery thrombosis, and portal vein thrombosis) who were admitted to the

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Section: Multivariate Analysis Of Risk Factors For Intestinal Necrosiscontrasting

confidence: 99%

Predictors and risk factors for intestinal necrosis in patients with mesenteric ischemia

Zhao¹,

Meng²,

Zhang³

et al. 2021

Ann Transl Med

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“…Since 2010, more than 158 patients with acute mesenteric ischemia have been administered in the ISC by a multidisciplinary stepwise management strategy, and a better outcome was achieved, as shown in previous reports [10,16,17]. However, in clinical practice and follow-up, we found that many patients with AMVT suffered from segmental intestinal stenosis in the long term, even though those patients successfully underwent mesenteric revascularization in the acute phase.…”

Section: Discussionsupporting

confidence: 61%

“…The condition of 5 patients worsened from mild symptoms to severe abdominal pain during initial nutrition therapy. Moreover, the worsen of intestinal stenosis and the increase in leukocyte counts may also indicate the aggravation of intestinal ischemia and the initiation of a systemic in ammatory response [16,27]. According to the comparison of enterography ndings in these patients, we hypothesize that "mucosal erosion-stricturecomplete obstruction" may also be the progression of PIIS secondary to AMVT to some extent.…”

Section: Discussionmentioning

confidence: 97%

Clinical Profile, Response to therapy and outcomes of post-ischemic intestinal stenosis Secondary to Acute Mesenteric Venous Thrombosis: a retrospective case series study

Sun

Wang

Chu

et al. 2020

Preprint

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Background Acute mesenteric venous thrombosis (AMVT) can not only cause acute bowel infarction but result in post-ischemic intestinal stenosis (PIIS), which is rarely reported. Methods Consecutive patients diagnosed with PIIS secondary to AMVT (during the post-thrombotic course, confirmed segmental bowel stenosis) from January 2010 to June 2018 were enrolled. We evaluated the clinical profile, response to therapy, and outcomes of this complication managed at the intestinal stroke center in China. Clinical data are retrospectively analyzed and Wilcoxon signed-rank test was used to evaluate the efficiency of conservative treatment. Results 42 patients with PIIS secondary to AMVT were evaluated. 20 (5-150) days after discharge for AMVT, symptoms of PIIS appeared, and the interval between symptom onset and consultation was 29.5 (2-180) days. In addition, abdominal pain (90.5%), abdominal distension (76.2%), weight loss (71.4%), and nausea or vomiting (54.8%) were the common presentations. Hypoproteinemia was observed in 61.9% of patients, while leukocytosis, anemia and electrolyte disorders were present in 11.9%, 45.2% and 35.7% of patients, respectively. CT excluded thrombosis recurrence and revealed extensive collateral circulation or portal cavernous transformation in 83.3% of patients. Enterography was required only in 81.0% of patients, with positive findings in all patients, including complete obstruction (23.5%), intestinal stricture (64.7%), and extensive mucosal erosion (11.8%). Prompt conservative treatment achieved significantly increases of albumin and pre-albumin levels and correction of electrolyte disorders (all p < 0.05). However, only 4 (9.5%) patients improved after conservative therapy and laparotomy was required in other patients. A median length of 20 (2-100) cm of involved bowel was resected, mainly involving the jejunum (76.3%). Only 1 patient died due to uncontrolled transverse colon bleeding, and other patients’ postoperative courses were uneventful. Conclusion During the post-thrombotic course, clinicians should be aware of the possibility of PIIS in patients with symptoms of ileus and hypoproteinemia. Patients may respond to conservative therapy; however, the majority of patients warrant surgical resection.

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“…Die positiv prädiktiven Werte für alpha-GST (alpha-glutathione S-transferase) und IMA (ischemia modified albumin) waren in den bisher wenigen Studien hierzu sehr variabel [9,11]. Die Autoren der Leitlinie empfehlen die Bestimmung des Laktatwerts, da dessen Höhe Rückschlüsse auf das Ausmaß einer möglichen Ischämie zulässt und damit prognostischen Wert hat [8,12,13]. Vorteilhafter scheint die Bestimmung globaler Infektwerte und zusätzlich spezi-fischer Marker, insbesondere D-Dimere, I-FABP, Leukozyten-/Lymphozytenzahl [8,10,11].…”

Section: Diagnostikunclassified

Akute (arterielle und venöse) Mesenterialischämie

Eckhardt¹,

Schmid²,

Grützmann³

2020

Allgemein- und Viszeralchirurgie up2date

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Outcomes and clinical characteristics of transmural intestinal necrosis in acute mesenteric ischemia

Cited by 27 publications

References 26 publications

Predictors and risk factors for intestinal necrosis in patients with mesenteric ischemia

Predictors and risk factors for intestinal necrosis in patients with mesenteric ischemia

Clinical Profile, Response to therapy and outcomes of post-ischemic intestinal stenosis Secondary to Acute Mesenteric Venous Thrombosis: a retrospective case series study

Akute (arterielle und venöse) Mesenterialischämie

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