Triple-vessel mesenteric ischaemia presenting with gastric ulceration

Loh, Julian Kenrick; O’Kelly, Fardod; Lim, Kheng Tian; Shields, William P.; Ravi, N.; Keeling, N; Reynolds, John V.

doi:10.1007/s11845-011-0672-x

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Так, жалобы на абдоминальные боли присутствовали лишь у 20,8% исследуемых с атеросклерозом МА, при этом выраженность их оказалась низкой. Несмотря на то, что в литературе описаны случаи одиночных и множественных язв желудка у пациентов с ХМИ, частота встречаемости эрозий и язв верхних отделов ЖКТ у пациентов без гемодинамически значимых стенозов МА ранее не изучалась [14,15].…”

Section: Discussionunclassified

Features of the upper gastrointestinal tract mucous membrane state in patients with atherosclerosis of the mesenteric arteries

Selyanina

Долгушина

Kuznetsova

et al. 2023

Terapevticheskii arkhiv

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Aim. To evaluate the clinical and endoscopic features of diseases of the upper gastrointestinal tract (GIT) in patients with atherosclerosis of the mesenteric arteries (MA). Materials and methods. The study included 48 patients with atherosclerosis of MA and 43 patients without atherosclerosis of MA, who were hospitalized in the department of vascular surgery of the Chelyabinsk Regional Clinical Hospital in the period from 2019 to 2021. All patients underwent multispiral computed tomoangiography of the visceral and lower limb arteries, esophagogastroduodenoscopy. Results. Assessment of lesions of the upper gastrointestinal tract revealed a higher incidence of erosive and ulcerative gastroduodenopathies among patients with atherosclerosis of MA (60.4%), compared with patients without atherosclerosis MA (39.5%); p=0.047. Signs of severe atrophy according to the data of histological examination were statistically significantly more frequent among patients with atherosclerosis of MA (29.2 and 11.6%; p=0.031). According to the results of logistic regression, the following predictors of erosions and ulcers of the upper gastrointestinal tract were revealed: the severity of stenosis of the superior mesenteric artery (SMA) is more than 35%, the body mass index (BMI) is less than 25.9 and the total score on the HADS scale is more than 6.5 points for depression (p=0.008). Conclusion. Erosive-ulcerative gastroduodenopathies and atrophy of the gastric mucosa are significantly more common in the group of patients with MA atherosclerosis. The main risk factors for erosions and ulcers of the upper gastrointestinal tract in patients with MA atherosclerosis are: the severity of SMA stenosis is more than 35%, a decrease in BMI is less than 25.9 and an increase in the HADS score is more than 6.5 points.

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Section: Discussionunclassified

Features of the upper gastrointestinal tract mucous membrane state in patients with atherosclerosis of the mesenteric arteries

Selyanina

Долгушина

Kuznetsova

et al. 2023

Terapevticheskii arkhiv

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“…В некоторых источниках также фигурирует термин «старческие язвы» [11,12]. В иностранной литературе они описываются как язвы желудка и ДПК на фоне хронической мезентериальной ишемии (ХМИ) и упоминаются лишь в описаниях клинических случаев [13,14]. Однако до настоящего времени практически от сутствуют исследования, посвященные оценке роли мезентериального атеросклероза и хронических нарушений висцеральной гемодинамики в генезе эрозивноязвенных гастродуоденопатий.…”

Section: Introductionunclassified

Features of stomach and duodenum peptic ulcer in patients with mesenteric atherosclerosis

et al. 2023

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Introduction. The high frequency of complicated forms of the stomach and duodenum peptic ulcer (PU) in patients with atherosclerosis requires the study of additional factors of ulcerogenesis in addition to infection with Helicobacter pylori (H. pylori) and the use of non-steroidal anti-inflammatory drugs (NSAIDs). Currently, there is no clear understanding of the role of mesenteric artery (MA) atherosclerosis in the development of gastroduodenal ulcers. The purpose of the study. To evaluate the contribution of MA atherosclerosis to the development of gastric and duodenal ulcer in patients with multifocal atherosclerosis. Material and methods. The study included 91 patients with atherosclerosis of two or more vascular beds in the period from 2019 to 2021. The examination included the determination of the gastrin-17, pepsinogen I, pepsinogen II and antibodies to H. pylori IgG concentration in blood serum, as well as multispiral computed tomoangiography of the abdominal aortic branches and esophagogastroduodenoscopy with histological examination. Results. The patients were divided into two groups: group I – 36 (39.6%) patients with PU, group II – 55 (60.4%) patients without PU. A more frequent occurrence of hemodynamically significant stenosis of the MA and a higher percentage of the superior mesenteric artery (SMA) stenosis in group I were noted. A positive correlation was found between the severity of erosive and ulcerative lesions and the percentage of SMA stenosis, levels of pepsinogen I and pepsinogen II. The combination of PU and MA atherosclerosis is characterized by a lesser severity of abdominal pain syndrome (p = 0.049). Risk factors for PU were identified: MA atherosclerosis (OR 4.953; CI 1.571–15.608); more than 8 points on the HADS depression scale (OR 2.970; CI 1.062–8.320) and on the Audit questionnaire (OR 5.787; CI 1.348–24.837). Conclusions. Risk factors for PU in patients with multifocal atherosclerosis were identified: MA atherosclerosis, subclinical depression, and health-threatening alcohol consumption. PU in patients with multifocal atherosclerosis is characterized by asymptomatic course.

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Upper gastrointestinal lesions in patients with lower extremity peripheral artery disease: data from a retrospective analysis

Selyanina

Долгушина

Фокин

et al. 2021

Cardiovasc Ther Prev

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Aim. To assess the prevalence and structure of upper gastrointestinal (GI) lesions, as well as the factors associated with their development, in patients with lower extremity peripheral artery disease (PAD).Material and methods. This retrospective analysis of medical records with lower extremity PAD includes data from 258 patients. All patients underwent multislice computed tomography angiography of abdominal aortic visceral branches and lower limb arteries, as well as esophagogastroduodenoscopy.Results. Endoscopic evidence of upper GI lesions was detected in 164 (63,6%) patients. In particular, gastroduodenal erosions and ulcers were observed in 57,8% of patients. All patients were divided into two groups: group I — 149 (57,8%) patients with gastroduodenal erosions and ulcers, group II — 109 (42,2%) patients without it. In group I patients, a higher incidence of mesenteric artery disease was recorded — 61,7 vs 43,1% (p=0,003). An independent factor associated with the development of gastroduodenal erosions and ulcers in patients with PAD is mesenteric artery disease (relative risk: 4,43; 95% confidence interval: 1,15-17,12 (p=0,031)).Conclusion. In patients with lower extremity PAD, upper GI diseases (63,6%) occur with a high frequency, while gastroduodenal erosions and ulcers was observed in 90,9% of them. The factors associated with the development of erosions and ulcers in patients with lower extremity PAD include mesenteric artery atherosclerosis.

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Triple-vessel mesenteric ischaemia presenting with gastric ulceration

Cited by 3 publications

References 15 publications

Features of the upper gastrointestinal tract mucous membrane state in patients with atherosclerosis of the mesenteric arteries

Features of the upper gastrointestinal tract mucous membrane state in patients with atherosclerosis of the mesenteric arteries

Features of stomach and duodenum peptic ulcer in patients with mesenteric atherosclerosis

Upper gastrointestinal lesions in patients with lower extremity peripheral artery disease: data from a retrospective analysis

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