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World Journal of Gastrointestinal Surgery 2022年第8期14卷 809-820页

作者： Shuh-Kuan Liau George Kuo Chao-Yu Chen Yueh-An Lu Yu-Jr Lin Cheng-Chia Lee Cheng-Chieh Hung Ya-Chung Tian Hsiang-Hao Hsu Department of Nephrology Kidney Research CenterChang Gung Memorial HospitalLinkou BranchCollege of MedicineChang Gung UniversityTaoyuan 333Taiwan Research Services Center for Health Information Chang Gung UniversityTaoyuan 333Taiwan

BACKGROUND mesenteric ischemia is significantly more common in end-stage kidney disease patients undergoing chronic dialysis than in the general population and is associated with high morbidity and mortality. However, reports on prognostic factors in this population are limited.AIM To elucidate the in-hospital outcomes of acute mesenteric ischemia in chronic dialysis patients and to analyze protective factors for survival.METHODS The case data of 426 chronic dialysis patients who were hospitalized in a tertiary medical center for acute mesenteric ischemia over a 14-year period were retrospectively reviewed. Of these cases, 103 were surgically confirmed, and the patients were enrolled in this study. A Cox regression analysis was used to evaluate the protective factors for survival.RESULTS The in-hospital mortality rate among the 103 enrolled patients was 46.6%.Univariate analysis was performed to compare factors in survivors and nonsurvivors, with better in-hospital outcomes associated with a surgery delay(defined as the time from onset of signs and symptoms to operation) mesenteric ischemia.

关键词： mesenteric ischemia Chronic dialysis End-stage kidney disease Surgery Protective factors Survival

Should we perform decompressive laparotomy during severe acute pancreatitis with intra-abdominal hypertension below 25 mmHg:Only the gut knows

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1470-1473页

作者： Thibault Vieille Melissa Crotet Celia Turco Paul Monasterolo Hadrien Winiszewski Gael Piton Medical Intensive Care Unit Besancon University HospitalBesancon 25000France Intensive Care Unit Vesoul HospitalVesoul 70000France Department of Digestive Surgical Oncology-Liver Transplantation Unit Besancon University HospitalBesancon 25000France Inserm UMRS-938 Centre de Recherche Saint-Antoine(CRSA)Sorbonne UniversitéParis 10041NY212France Intensive Care Unit Nord Franche Comte HospitalTrevenans 90400France

We suggest that during severe acute pancreatitis(SAP)with intra-abdominal hypertension,practitioners should consider decompressive laparotomy,even with intra-abdominal pressure(IAP)below 25 mmHg.Indeed,in this setting,non-occlusive mesenteric ischemia(NOMI)may occur even with IAP below this cutoff and lead to transmural necrosis if abdominal perfusion pressure is not promptly restored.We report our experience of 18 critically ill patients with SAP having undergone decompressive laparotomy of which one third had NOMI while IAP was mostly below 25 mmHg.

关键词： Acute pancreatitis Abdominal compartment syndrome Decompressive laparotomy mesenteric ischemia Intra-abdominal pressure Abdominal perfusion pressure

mesenteric ischemia in COVID-19 patients:A review of current literature

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World Journal of Clinical Cases 2021年第18期9卷 4700-4708页

作者： Asad Ali Kerawala Bhagwan Das Ahda Solangi Department of Surgery Cancer Foundation HospitalKarachi 75300Pakistan Department of Medicine Cancer Foundation HospitalKarachi 75300Pakistan New York Medical College ValhallaNY 10595United States

BACKGROUND Coronavirus disease 2019(COVID-19)virus has affected all the systems of the body,defying all impressions of it being a respiratory virus only.AIM To see the association of mesenteric ischemia with COVID-19.METHODS After initial screening and filtering of the titles on PubMed and Google Scholar,124 articles were selected.Articles were read in full,and the references were skimmed for relevance.Twenty-six articles(case reports and case series)were found to eligible for inclusion.References of these 26 articles were checked for any additional cases.Two more publications were found,and a total of 28 articles(22 case reports and 6 case series)have been included for review in this manuscript.RESULTS A total of 41 cases of acute mesenteric ischemia in COVID-19 patients have been reported in the literature since the outbreak of this pandemic.Most of them include patients with comorbidities.CONCLUSION In conclusion,based on this literature review and precise published knowledge regarding acute mesenteric ischemia in patients with COVID-19,it is essential to understand its relevance in all patients with gastrointestinal symptoms.The threshold for the diagnostic investigations should also be kept low for the timely diagnosis and management of this disorder.

关键词： mesenteric ischemia COVID-19 SARS-CoV-2 Influenza Severe acute respiratory syndrome Acute abdomen

Non-occlusive mesenteric ischemia: Diagnostic challenges and perspectives in the era of artificial intelligence

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World Journal of Gastroenterology 2021年第26期27卷 4088-4103页

作者： Simon Bourcier Julian Klug Lee S Nguyen Department of Intensive Care Medicine University Hospital of GenevaGeneva 1201Switzerland Department of Internal Medicine Groupement Hospitalier de l’Ouest LémaniqueNyon 1260Switzerland Department of Intensive Care Medicine CMC Ambroise ParéNeuilly-sur-Seine 92200France

Acute mesenteric ischemia(AMI)is a severe condition associated with poor prognosis,ultimately leading to death due to multiorgan failure.Several mechanisms may lead to AMI,and non-occlusive mesenteric ischemia(NOMI)represents a particular form of AMI.NOMI is prevalent in intensive care units in critically ill patients.In NOMI management,promptness and accuracy of diagnosis are paramount to achieve decisive treatment,but the last decades have been marked by failure to improve NOMI prognosis,due to lack of tools to detect this condition.While real-life diagnostic management relies on a combination of physical examination,several biomarkers,imaging,and endoscopy to detect the possibility of several grades of NOMI,research studies only focus on a few elements at a time.In the era of artificial intelligence(AI),which can aggregate thousands of variables in complex longitudinal models,the prospect of achieving accurate diagnosis through machine-learning-based algorithms may be sought.In the following work,we bring you a state-of-the-art literature review regarding NOMI,its presentation,its mechanics,and the pitfalls of routine work-up diagnostic exams including biomarkers,imaging,and endoscopy,we raise the perspectives of new biomarker exams,and finally we discuss what AI may add to the field,after summarizing what this technique encompasses.

关键词： mesenteric ischemia Biomarkers Critically ill Machine learning Artificial intelligence

A hybrid technique： intra-arterial catheter-directed thrombolysis following the recanalization of superior mesenteric artery in acute mesenteric ischemia

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Chinese Medical Journal 2013年第7期126卷 1381-1383页

作者： ZHU Jie-chang DAI Xiang-chen FAN Hai-lun FENG Zhou ZHANG Yi-wei LUO Yu-dong Department of General Surgery General Hospital of Tianjin Medical University Tianjin 300052 China

Acute mesenteric ischemia is a deadly process withoverall mortality rate of 40%. Acute thrombosis of an atherosclerotic lesion with previous partial occlusion isone of the common causes. Peri-operative mortality ofsu... 详细信息

关键词： superior mesenteric artery mesenteric ischemia thrombosis embolectomy angioplasty intra-arterial catheter-directed thrombolysis

Portal vein gas combined with pneumatosis intestinalis and emphysematous cystitis:A case report and literature review

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World Journal of Clinical Cases 2022年第25期10卷 8945-8953页

作者： Shi-Fu Hu Han-Bo Liu Yuan-Yuan Hao Department of General Surgery Tianjin Xiqing HospitalTianjin 300100China Department of Geriatrics Tianjin Xiqing HospitalTianjin 300100China

BACKGROUND Portal venous gas(PVG)is a rare clinical condition usually indicative of severe disorders,including necrotizing enterocolitis,bowel ischemia,or bowel wall rupture/infarction.Pneumatosis intestinalis(PI)is a rare illness characterized by an infiltration of gas into the intestinal wall.Emphysematous cystitis(EC)is relatively rare and characterized by intramural and/or intraluminal bladder gas best depicted by cross-sectional imaging.Our study reports a rare case coexistence of PVG presenting with PI and EC.CASE SUMMARY An 86-year-old woman was admitted to the emergency room due to the progressive aggravation of pain because of abdominal fullness and distention,complicated with vomiting and stopping defecation for 4 d.The abdominal computed tomography(CT)plain scan indicated intestinal obstruction with ischemia changes,gas in the portal vein,left renal artery,superior mesenteric artery,superior mesenteric vein,some branch vessels,and bladder pneumatosis with air-fluid levels.Emergency surgery was conducted on the patient.Ischemic necrosis was found in the small intestine approximately 110 cm below the Treitz ligament and in the ileocecal junction and ascending colon canals.This included excision of the necrotic small intestine and right colon,fistulation of the proximal small intestine,and distal closure of the transverse colon.Subsequently,the patient displayed postoperative short bowel syndrome but had a good recovery.She received intravenous fluid infusion and enteral nutrition maintenance every other day after discharge from the community hospital.CONCLUSION Emergency surgery should be performed when CT shows signs of PVG with PI and EC along with a clinical situation strongly suggestive of bowel ischemia.

关键词： Portal vein gas mesenteric ischemia Pneumatosis intestinalis Emphysematous cystitis Bowel necrosis Case report

Superior mesenteric vein thrombosis induced by influenza infection:A case report

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World Journal of Clinical Cases 2020年第18期8卷 4193-4199页

作者： Gyu Man Oh Kyoungwon Jung Jae Hyun Kim Sung Eun Kim Won Moon Moo In Park Seun Ja Park Department of Internal Medicine Kosin University College of MedicineBusan 49267South Korea

BACKGROUND Among the various types and causes of mesenteric ischemia,superior mesenteric vein(SMV)thrombosis is a rare and ambiguous disease.If a patient presents with SMV thrombosis,past medical history should be reviewed,and the patient should be screened for underlying disease.SMV thrombosis may also occur due to systemic infection.In this report,we describe a case of SMV thrombosis complicated by influenza B infection.CASE SUMMARY A 64-year-old male visited the hospital with general weakness,muscle aches,fever,and abdominal pain.The patient underwent computed tomography(CT)and was diagnosed with SMV thrombosis.Since the patient’s muscle pain and fever could not be explained by the SMV thrombosis,the clinician performed a test for influenza,which produced a positive result for influenza B.The patient had a thrombus in the SMV only,with no invasion of the portal or splenic veins,and was clinically stable.Anticoagulation treatment was prescribed without surgery or other procedures.The follow-up CT scan showed improvement,and the patient was subsequently discharged with continued oral anticoagulant treatment.CONCLUSION This case provides evidence that influenza may be a possible risk factor for SMV thrombosis.If unexplained abdominal pain is accompanied by an influenza infection,examination of an abdominal CT scan may be necessary to screen for possible SMV thrombosis.

关键词： Influenza B virus mesenteric ischemia Venous thrombosis mesenteric vascular occlusion Influenza Human Case reports

Enterocolic phlebitis:a rare cause of bowel ischemia and review of the literature

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Gastroenterology Report 2023年第1期11卷 24-31页

作者： Stefanie Bowee Sophia B.Matter Heather Dawson Roman A.Inglin Department of General Surgery Spital InterlakenUnterseenSwitzerland Institute of Pathology University of BernBernSwitzerland

Enterocolic phlebitis(EP)is a rare cause of bowel ischemia due to isolated venulitis of the bowel wall and mesentery without arterial involvement.EP is often misdiagnosed as inﬂammatory bowel disease,carcinoma,or diverticulitis due to non-speciﬁc symptoms as well as non-speciﬁc clinical and radiologicalﬁndings.While unresponsive to pharmacotherapy,surgical resection of the affected bowel appears to be the only successful therapy with a very low recurrence rate.Etiology of EP remains unknown.We report a case of EP with rare presentation in the left hemicolon and unusual histologicalﬁndings emphasizing the heterogeneity of this cause of enterocolic ischemia.The review and comparison of the three enti-ties—EP,mesenteric inﬂammatory veno-occlusive disease(MIVOD),and idiopathic myointimal hyperplasia of mesenteric veins(IMHMV),all describing patterns of bowel ischemia due to isolated pathology of mesenteric veins—reveal that the current terminology is unclear.EP and MIVOD are very similar and may be considered the same disease.IMHMV,though,differs in localization,symptom duration,and histologicalﬁndings but also shares features with EP and MIVOD.Further studies and harmonized terminology are inevitable for better understanding of the disease,prevention of unnecessary pharmacotherapy,and reduction in time to diagnosis.

关键词： phlebitis acute abdomen mesenteric vascular occlusion mesenteric ischemia colectomy case report

Uncommon Ethiology in Abdominal Pain: Celiac Axis Compression Syndrome

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Open Journal of Gastroenterology 2016年第1期6卷 1-4页

作者： Serife Degirmencioglu Banu Boyuk Hande Atalay Muhammed Ates Murat Altay Aslan Celebi Ismail Ekizoglu Department of Internal Medicine Gaziosmanpasa Taksim Education and Research Hospital Istanbul Turkey Department of Internal Medicine Gebze Fatih Government Hospital Kocaeli Turkey

Celiac axis compression syndrome, one of the reasons of mesenteric ischemia, is an extremely rare etiology of abdominal pain. Primary pathological mechanism is the external compression of the celiac trunk by median arcuate ligament. The diagnosis of this condition is usually difficult and depends on angiographic findings and computerized tomography (CT) evaluations. Here we report a celiac axis compression syndrome case, presenting with chronic abdominal pain and weight loss, which was successfully treated by surgery.

关键词： Abdominal Pain mesenteric ischemia Median Arcuate Ligament Celiac Artery Compression

3.0T MR Imaging Appearance of Small Intestinal Wall Layers in Vivo Study

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3.0T MR Imaging Appearance of Small Intestinal Wall Layers i...