Acute mesenteric ischemia (AMI) is a rare, yet deadly thromboembolic accident that requires urgent surgery and or revascularization. We report the case of a 67-year-old male patient, who presented with severe abdominal pain and reduced oral intake, causing dehydration and impaired kidney function. The imaging evaluation including arterial Doppler and computed tomography (CT) scan showed AMI caused by superior mesenteric artery (SMA) obstruction and celiac artery stenosis, besides multiple atherosclerotic segments. Given the absence of guidelines in such an uncommon combination, a multidisciplinary management was initiated involving general medicine, general surgery, vascular surgery, and radiology. The agreed plan consisted of anticoagulation, exploratory laparotomy with necrosis resection and anastomosis, followed by percutaneous thrombectomy and angioplasty with stenting. The patient was discharged on day 7 postop with a highly satisfactory outcome and follow up. This case highlights the value of an early multidisciplinary approach in tailoring the management to the specific case of AMI.
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http://dx.doi.org/10.11604/pamj.2023.44.18.35959 | DOI Listing |
Ther Clin Risk Manag
December 2024
Department of General Surgery, School of Medicine, Ibb University, Ibb, Yemen.
Background: Recognizing factors that predict non-operative management (NOM) failure for patients with small bowel obstruction (SBO) aids in limiting surgical intervention when needed. This study investigated the predictive factors for NOM failure in SBO patients in a resource-limited setting.
Material And Method: A retrospective study included 165 patients who were diagnosed with SBO and were admitted and managed at Althora General Hospital, IBB, Yemen, from April 2022 to March 2024.
World J Gastrointest Surg
December 2024
State Key Laboratory of Organ Failure Research, Department of General Surgery, Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
Background: Intestinal ischemiareperfusion (I/R) injury (II/RI) is a critical condition that results in oxidative stress, inflammation, and damage to multiple organs. Zinc, an essential trace element, offers protective benefits in several tissues during I/R injury, but its effects on intestinal II/RI remain unclear.
Aim: To investigate the effects of zinc pretreatment on II/RI and associated multiorgan damage.
J Vasc Surg Venous Lymphat Disord
December 2024
Division of Vascular Surgery, UPMC, Pittsburgh, Pennsylvania; Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address:
Background: Portal venous system aneurysms (PVA) are increasingly diagnosed on cross-sectional computed tomography (CT) imaging. However, the natural history of these aneurysms is poorly understood and reports are limited to small case series.
Methods: Terms relevant to PVA were searched in radiology reports (2010-2022) with PVA presence confirmed by manual review.
Cureus
November 2024
Internal Medicine and Diabetes and Endocrinology, Barking, Havering and Redbridge National Health Service (NHS) Hospital Trust, London, GBR.
Aortic dissection (AD) is a medical emergency that occurs as a result of a compromise in the structural integrity of the aorta. If left untreated, AD can have severe consequences such as organ dysfunction or even death. Malperfusion syndrome is a major complication of aortic dissection with mesenteric malperfusion syndrome being a rare but devastating form that can lead to mesenteric ischemia and is associated with poor prognosis despite timely management.
View Article and Find Full Text PDFGastroenterology
December 2024
Division of Gastroenterology and Hepatology, Department of Medicine, Endeavor Health, Chicago, Illinois.
Description: Portal vein thromboses (PVTs) are common in patients with cirrhosis and are associated with advanced portal hypertension and mortality. The treatment of PVTs remains a clinical challenge due to limited evidence and competing risks of PVT-associated complications vs bleeding risk of anticoagulation. Significant heterogeneity in PVT phenotype based on anatomic, host, and disease characteristics, and an emerging spectrum of therapeutic options further complicate PVT management.
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