scholarly journals Acute Mesenteric Ischemia in a COVID-19 Patient: Delay in Referral and Recommendation for Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Mohammad Hossein Bagheripour ◽  
Mohammad Ali Zakeri
Keyword(s):  
Abdominal Surgery ◽  
Mesenteric Ischemia ◽  
Correct Diagnosis ◽  
Acute Mesenteric Ischemia ◽  
Patient Delay ◽  
Shortness Of Breath ◽  
Gi Symptoms ◽  
Thrombotic Complications ◽  
Timely Referral

Coronavirus (COVID-19) is more common with symptoms such as fever, dry cough, and shortness of breath. However, it may be associated with COVID-19-induced gastrointestinal (GI) symptoms including acute mesenteric ischemia (AMI). These conditions make the diagnosis of AMI challenging. Timely referral with correct diagnosis and attention to the uncommon symptoms of COVID-19 can play an important role in the management and treatment of AMI in COVID-19 patients. We present a patient with AMI due to thrombotic complications of COVID-19, who referred to the hospital too late and ignored the recommendation for abdominal surgery.

Nonocclusive Mesenteric Ischemia: A Lethal Complication in Peritoneal Dialysis Patients

2007 ◽  
Vol 27 (2) ◽  
pp. 136-141 ◽  
Author(s):  
Fotios Archodovassilis ◽  
Emmanuel E. Lagoudiannakis ◽  
Dimitrios Konstantinos Tsekouras ◽  
Konstantinos Vlachos ◽  
Konstantinos Albanopoulos ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Mesenteric Ischemia ◽  
Intestinal Ischemia ◽  
Correct Diagnosis ◽  
Acute Mesenteric Ischemia ◽  
Dialysis Patients ◽  
Nonocclusive Mesenteric Ischemia ◽  
Stage Renal Disease ◽  
End Stage ◽  
High Index Of Suspicion

Nonocclusive mesenteric ischemia (NOMI) is a relatively uncommon disorder, seen primarily in elderly patients with cardiac disease, and is characterized by progressive intestinal ischemia leading to infarction, sepsis, and death. It is suspected of being the underlying cause in at least 20% – 30% of acute mesenteric ischemia patients. End-stage renal disease patients are among the highest risk populations for developing this lethal complication; however, NOMI is not unique to hemodialysis and can occur in peritoneal dialysis patients as well. Unfortunately, the presentation of NOMI is very similar to that of peritonitis. The key to correct diagnosis is a high index of suspicion in predisposed patients. The high mortality rate is a clear reflection of failure to recognize the syndrome at an earlier, treatable stage. We present our case experience and an extensive review of the literature regarding this dreadful complication that may be reversible if considered early as a possible etiology and the appropriate diagnostic maneuvers undertaken.

Laryngeal Manifestations of Autoimmune Diseases

2020 ◽  
Vol 5 (2) ◽  
pp. 439-456
Author(s):  
Jenny L. Pierce
Keyword(s):  
Autoimmune Disease ◽  
Autoimmune Diseases ◽  
Patient Outcomes ◽  
Correct Diagnosis ◽  
Upper Airway ◽  
Clinical Implications ◽  
Laryngeal Function ◽  
The Past ◽  
Referral Practices ◽  
Timely Referral

Purpose This review article provides an overview of autoimmune diseases and their effects on voice and laryngeal function. Method A literature review was conducted in PubMed. Combinations of the following keywords were used: “autoimmune disease and upper airway,” “larynx,” “cough,” “voice,” “dysphonia,” and “dyspnea.” Precedence was given to articles published in the past 10 years due to recent advances in this area and to review articles. Ultimately, 115 articles were included for review. Results Approximately 81 autoimmune diseases exist, with 18 of those highlighted in the literature as having laryngeal involvement. The general and laryngeal manifestations of these 18 are discussed in detail, in addition to the clinical implications for a laryngeal expert. Conclusions Voice, breathing, and cough symptoms may be an indication of underlying autoimmune disease. However, these symptoms are often similar to those in the general population. Appropriate differential diagnosis and timely referral practices maximize patient outcomes. Guidelines are provided to facilitate correct diagnosis when an autoimmune disease is suspected.

Acute mesenteric ischemia with necrosis of entire small intestine

2019 ◽  
Vol 98 (4) ◽  
pp. 174-177
Keyword(s):  
Small Intestine ◽  
Mesenteric Ischemia ◽  
Severe Disease ◽  
Acute Mesenteric Ischemia ◽  
Diagnostic Methods ◽  
Entire Small Intestine ◽  
Common Etiology

The case study describes a case of a patient with acute mesenteric ischemia with necrosis of entire small intestine. In following text there is an overview of the incidence of acute mesenteric ischemia, its most common etiology, diagnostic methods and treatment of this severe disease.

Use of indocianine green fluorescence in acute mesenteric ischemia

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Jaime Bonnín-Pascual
Keyword(s):  
Indocyanine Green ◽  
Terminal Ileum ◽  
Mesenteric Ischemia ◽  
Intestinal Anastomosis ◽  
Acute Mesenteric Ischemia ◽  
Left Colon ◽  
Infrared Light ◽  
High Morbidity ◽  
Green Fluorescence ◽  
Clinical Cases

Introduction: Acute mesenteric ischemia has a high morbidity and mortality and constitutes an intraoperative challenge in the management of ischemic areas. In this context, we analyze the use of indocyanine green fluorescence to assess intestinal vascularization through 3 clinical cases. Case presentation: we present 3 clinical cases operated for acute mesenteric ischemia. Evaluation of intestinal viability is performed under infrared light after intravenous infusion of 25 mg of indocyanine green. Case 1 is a 42-year-old male with multiple antecedents of severe vascular disease, presenting with a massive acute mesenteric ischemia involving multiple intestinal segments. Fluorescence allows two adjusted bowel resections with double intestinal anastomosis. Case 2 is a 74-year-old woman with a history of non-anticoagulated atrial fibrillation who is decided to perform an urgent surgery when an esophageal, gastric and portal system pneumatosis is observed, as indirect signs of ischemia, in urgent CT. During the surgical act there is an ischemia of the terminal ileum and right colon without clear signs of involvement at the esophageal-gastric level. The assessment after administration of ICG discriminates the clear ischemic involvement from terminal ileum to ascending colon and patched in the transverse and left colon, without esophageal or gastric involvement. Case 3 is a 49-year-old woman with aortoiliac and visceral Takayasu disease and revascularization surgery of the celiac trunk. Given the increase in abdominal pain, a new CT scan demonstrates colonic pneumatosis. Urgent laparotomy shows necrosis at the level of the left colon and hypoperfusion of the cecum. The administration of ICG finds a lack of uptake of the entire colon. A subtotal colectomy with ileostomy and mucous fistula is performed. Introduction: Acute mesenteric ischemia has a high morbidity and mortality and constitutes an intraoperative challenge in the management of ischemic areas. In this context, we analyze the use of indocyanine green fluorescence to assess intestinal vascularization through 3 clinical cases. Case presentation: we present 3 clinical cases operated for acute mesenteric ischemia. Evaluation of intestinal viability is performed under infrared light after intravenous infusion of 25 mg of indocyanine green. Case 1 is a 42-year-old male with multiple antecedents of severe vascular disease, presenting with a massive acute mesenteric ischemia involving multiple intestinal segments. Fluorescence allows two adjusted bowel resections with double intestinal anastomosis. Case 2 is a 74-year-old woman with a history of non-anticoagulated atrial fibrillation who is decided to perform an urgent surgery when an esophageal, gastric and portal system pneumatosis is observed, as indirect signs of ischemia, in urgent CT. During the surgical act there is an ischemia of the terminal ileum and right colon without clear signs of involvement at the esophageal-gastric level. The assessment after administration of ICG discriminates the clear ischemic involvement from terminal ileum to ascending colon and patched in the transverse and left colon, without esophageal or gastric involvement. Case 3 is a 49-year-old woman with aortoiliac and visceral Takayasu disease and revascularization surgery of the celiac trunk. Given the increase in abdominal pain, a new CT scan demonstrates colonic pneumatosis. Urgent laparotomy shows necrosis at the level of the left colon and hypoperfusion of the cecum. The administration of ICG finds a lack of uptake of the entire colon. A subtotal colectomy with ileostomy and mucous fistula is performed. Conclusions: The fluorescence with ICG provides a better visualization of the intestinal vascularization in the AMI, and allows to determine the limits of the affected tissue to perform adjusted resections.

D-dimer as a marker for early diagnosis of acute mesenteric ischemia

2006 ◽  
Vol 117 (4) ◽  
pp. 463-467 ◽  
Author(s):  
Hüseyin Altinyollar ◽  
Mustafa Boyabatli ◽  
Uğur Berberoğlu
Keyword(s):  
Early Diagnosis ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
D Dimer

scholarly journals Late Vascular Intervention for Acute Mesenteric Ischemia Is Associated with Early Mortality and Extensive Bowel Resection

2021 ◽  
Vol 73 (3) ◽  
pp. 48-49
Author(s):  
Lillian M. Tran ◽  
Elizabeth Andraska ◽  
Rafael Ramos-Jiminez ◽  
Andrew-Paul Deeb ◽  
Natalie Sridharan ◽  
...  
Keyword(s):  
Mesenteric Ischemia ◽  
Bowel Resection ◽  
Acute Mesenteric Ischemia ◽  
Early Mortality ◽  
Vascular Intervention

scholarly journals Case report: direct revascularization in acute mesenteric ischemia by an endovascular approach

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
P. Genzel ◽  
L. C. van Dijk ◽  
H. T. C. Veger ◽  
J. J. Wever ◽  
R. G. S. van Eps ◽  
...  
Keyword(s):  
Case Report ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Endovascular Approach
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