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Transplant Direct 2021 Mar 11;7(3):e670. Epub 2021 Feb 11.

Department of Surgery, Duke University Hospital, Durham, NC.

Explantation of native viscera in multivisceral transplant candidates, particularly in those with extensive portomesenteric thrombosis (PMT), carries considerable morbidity due to extensive vascularized adhesions. Preemptive visceral angioembolization has been previously described as a technique to minimize excessive blood loss during mobilization of the native viscera but is not well described specifically in patients with extensive PMT.

Methods: In a series of 5 patients who underwent mutivisceral transplant for PMT from June 2015 to November 2018, we performed preoperative superior mesenteric, splenic, and hepatic artery embolization to reduce blood loss during explanation and evaluated the blood loss and blood product utilization, as well as 30-day rates of infectious complications. Read More

SAGE Open Med Case Rep 2021 20;9:2050313X211004804. Epub 2021 May 20.

Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Superior mesenteric artery embolisation is the most common cause of acute mesenteric ischaemia. Superior mesenteric artery embolisation can be caused by various cardiac diseases (myocardial ischaemia or infarction, atrial tachyarrhythmias, endocarditis, cardiomyopathies, ventricular aneurysms and valvular disorders), arterial aneurysms, ulcerated atherosclerotic plaques of the major arteries and others. A case of 65-year-old, previously healthy man with superior mesenteric artery embolism, who was found to also have mural aortic thrombi, is presented. Read More

Life Sci 2021 Jun 2;279:119676. Epub 2021 Jun 2.

Institute of Experimental Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation. Electronic address:

Aims: The effects of three types of bariatric interventions on myocardial infarct size were tested in the rat model of type 2 diabetes mellitus (T2DM). We also evaluated the effects of bariatric surgery on no-reflow phenomenon and vascular dysfunction caused by T2DM.

Main Methods: Rats with T2DM were assigned into groups: without surgery, sham-operated, ileal transposition, Roux-en-Y gastric bypass, and sleeve gastrectomy. Read More

United European Gastroenterol J 2021 Jun 2. Epub 2021 Jun 2.

Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Background: The mesenteric artery calcium score (MACS) identifies patients with possible chronic mesenteric ischaemia (CMI) using standard computed tomography (CT) imaging. The MACS does not necessitate a dedicated computed tomography angiography (CTA) which is required for evaluation of mesenteric artery patency. This study aimed to test the use of a symptom and MACS based score chart to facilitate the selection of patients with a low probability of CMI, in whom further diagnostic workup can be omitted, and to validate the CTA-based score chart proposed by van Dijk et al. Read More

Biomedicines 2021 May 26;9(6). Epub 2021 May 26.

Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.

Gastric pentadecapeptide BPC 157 therapy counteracts multiple organ dysfunction syndrome in rats, which have permanent occlusion of the superior mesenteric artery close to the abdominal aorta. Previously, when confronted with major vessel occlusion, its effect would rapidly activate collateral vessel pathways and resolve major venous occlusion syndromes (Pringle maneuver ischemia, reperfusion, Budd-Chiari syndrome) in rats. This would overwhelm superior mesenteric artery permanent occlusion, and result in local, peripheral, and central disturbances. Read More

Antioxidants (Basel) 2021 May 27;10(6). Epub 2021 May 27.

Department of Surgery and Radiology and Physical Medicine, University of The Basque Country, ES48940 Leioa, Biscay, Spain.

Intestinal ischemia-reperfusion injury (i-IRI) is a rare disorder with a high mortality rate, resulting from the loss of blood flow to an intestinal segment. Most of the damage is triggered by the restoration of flow and the arrival of cytokines and reactive oxygen species (ROS), among others. Inactivation of these molecules before tissue reperfusion could reduce intestinal damage. Read More

Fundam Clin Pharmacol 2021 Jun 1. Epub 2021 Jun 1.

Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Background: Over the past decades, great attention has been given to the nervous system modulating effects on the immune response in inflammation-associated injuries, such as acute intestinal ischemia-reperfusion (IR). Recently we proved the anti-inflammatory and antioxidant effects of 5-hydroxytryptamine (5-HT)1B/1D receptors in intestinal IR injury in rats. Also, the alpha7 nicotinic acetylcholine (α7-nACh) receptor has anti-inflammatory effects in different inflammation-associated injuries. Read More

CVIR Endovasc 2021 Jun 1;4(1):45. Epub 2021 Jun 1.

Department of Cardiovascular Medicine, Sendai Kousei Hospital, 4-15 Hirose-cho, Aoba-ku, Sendai, Miyagi, 980-0873, Japan.

Background: Mesenteric ischaemia is often a manifestation of severe vascular disease involving the superior mesenteric artery (SMA). Endovascular revascularization is challenging in a chronic total occlusion (CTO) of SMA.

Case Presentation: A-73-year-old male patient was referred to our hospital because of a 2-year history of post prandial abdominal angina. Read More

J Endovasc Ther 2021 May 26:15266028211016447. Epub 2021 May 26.

German Aortic Center, Department of Vascular Medicine, University Heart & Vascular Center Hamburg, Germany.

Purpose: This study describes technical success, feasibility, and early results of fenestrated and branched endovascular aortic repair (F/B-EVAR) for treatment of thoracoabdominal aortic aneurysms (TAAAs) or pararenal aneurysms with more than 4 target visceral vessels (TVs) due to renovisceral arterial anatomical variations.

Materials And Methods: Patients with TAAAs or pararenal aortic aneurysms who had more than 4 TVs due to renovisceral arterial anatomical variations of renal, celiac, and/or superior mesenteric arteries and received F/B-EVAR between January 2017 and September 2019 at a single aortic center were included in this study. We analyzed technical success, feasibility, and early outcomes. Read More

Med J Malaysia 2021 May;76(3):426-428

Sarawak General Hospital, Department of Radiology, Sarawak, Malaysia.

Acute mesenteric ischemia (AMI) is an emergency associated with a high mortality rate. A high index of clinical suspicion, prompt diagnosis and treatment is necessary to improve the patient outcome. The principle of damage control surgery should be adopted in the management of critically ill surgical patients with AMI. Read More

Med Sci Monit 2021 May 19;27:e930478. Epub 2021 May 19.

Department of Anesthesiology, Fifth People's Hospital, Fudan University, Shanghai, China (mainland).

BACKGROUND Propofol improves rodent pulmonary injury after intestinal ischemia-reperfusion (IIR). However, its effect and underlying mechanisms in large animals remain unclear. Here, we examined whether pretreatment with propofol could relieve lung injury during IIR in pigs, then investigated the underlying mechanism. Read More

Niger J Physiol Sci 2020 Dec 31;35(2):209-212. Epub 2020 Dec 31.

Department of Veterinary Surgery and Radiology.

Intestinal Ischaemia-Reperfusion Injury as distinct from Ischaemia-Reperfusion Injury is what occurs when blood supply to the intestines is cut off either inadvertently in some gastrointestinal emergencies or during abdominal surgical interventions. The phenomenon leads to formation of reactive oxygen species and subsequent up-regulation upon reaching the spleen and consequent effects in organs of the body such as increased sperm cell abnormalities. The changes which occur in the intestine and some distant organs due to remote effects of intestinal ischaemia-reperfusion have been demonstrated but there is paucity of information on these effects on the testes with implications on fertility which was investigated in this study. Read More

Cureus 2021 May 13;13(5):e14998. Epub 2021 May 13.

General and Colorectal Surgery, Bogazici Academy for Clinical Sciences, Istanbul, TUR.

Acute rectal ischemia is a rare entity because the rectum has abundant blood supply from the inferior mesenteric, internal iliac, internal pudendal, and marginal artery with rich collaterals. We present a case of an acute ischemic proctosigmoiditis with a history of rectal cancer who completely recovered after total neoadjuvant treatment and was in the "watch-and-wait" protocol. Urgent laparoscopic low anterior resection and protective ileostomy were performed. Read More

Kyobu Geka 2021 May;74(5):388-391

Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.

A 50-year-old man presented with abdominal pain and numbness in the right leg. He was diagnosed with type A acute aortic dissection with malperfusion of the superior mesenteric artery(SMA) and the right external iliac artery. Before median sternotomy, we made median celiotomy and anastomosed a saphenous vein graft to SMA. Read More

Clinics (Sao Paulo) 2021 5;76:e2513. Epub 2021 May 5.

Departamento de Cirurgia, Disciplina de Anestesiologia, Dor e Medicina Intensiva, Universidade Federal de Sao Paulo, Sao Paulo, SP, BR.

Objectives: The current study compared the impact of pretreatment with melatonin and N-acetylcysteine (NAC) on the prevention of rat lung damage following intestinal ischemia-reperfusion (iIR).

Methods: Twenty-eight Wistar rats were subjected to intestinal ischemia induced by a 60 min occlusion of the superior mesenteric artery, followed by reperfusion for 120 min. Animals were divided into the following groups (n=7 per group): sham, only abdominal incision; SS+iIR, pretreated with saline solution and iIR; NAC+iIR, pretreated with NAC (20 mg/kg) and iIR; MEL+iIR, pretreated with melatonin (20 mg/kg) and iIR. Read More

Front Pharmacol 2021 22;12:629125. Epub 2021 Apr 22.

Department of Pharmacy, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China.

There is a high incidence of radiation enteritis (RE) after abdominal radiotherapy. The occurrence of RE seriously affects the treatment and quality of life of patients; however, its pathogenesis is complex and there are no effective drugs for its prevention or treatment. Intestinal ischemia plays an important role in the occurrence of enteritis. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2021 Apr;46(4):400-403

Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha 410008, China.

Objectives: Thoracoabdominal aortic aneurysm (TAAA) prosthetic vessel replacement is one of the most complex operations in the field of cardiovascular surgery. The key to success of this operation is to prevent and avoid ischemia of important organs while repairing TAAA. This study aims to summarize and analyze the effect of prosthetic vessel replacement under left heart bypass in the treatment of TAAA. Read More

Eur J Vasc Endovasc Surg 2021 May 5. Epub 2021 May 5.

Department of Vascular and Thoracic Surgery, Bichat Hospital, Paris (Assistance Publique Hôpitaux de Paris - AP-HP), France; SURVI (Structure d'URgences Vasculaires Intestinales), Intestinal Stroke Centre, Assistance Publique Hôpitaux de Paris (AP-HP), France; Université de Paris, Paris, France.

Objective: To report the intra-operative adverse events (IOAEs) and the initial and one year outcomes of retrograde open mesenteric stenting (ROMS) using balloon expandable covered stents for acute and chronic mesenteric ischaemia.

Methods: Clinical data and outcomes of all consecutive patients treated with ROMS for acute and chronic mesenteric ischaemia at an intestinal stroke centre between November 2012 and September 2019 were reviewed. ROMS was performed using balloon expandable covered stents. Read More

EJVES Vasc Forum 2021 19;50:12-18. Epub 2020 Dec 19.

Vascular Surgery Department, Bordeaux University Hospital, Bordeaux, France.

Introduction: Alarming outcomes have been reported following infected endovascular aortic aneurysm repair (EVAR) device explantation. Infected fenestrated EVAR (FEVAR) exposes patients to even worse procedural risks.

Report: A 67 year old man with a prior history of FEVAR presented with impaired general condition, abdominal and back pain, and increased C reactive protein. Read More

HPB (Oxford) 2021 Apr 20. Epub 2021 Apr 20.

Department of Hepato-Biliary-Pancreatic Surgery and Liver Transplantation, Haut Lévêque Hospital, CHU de Bordeaux, Bordeaux, France; Department of Research, INSERM UMR 1035, CHU Bordeaux, France. Electronic address:

Background: Sacrificing a replaced right hepatic artery (rRHA) from the superior mesenteric artery is occasionally necessary to obtain an R0 resection after pancreaticoduodenectomy (PD) for pancreatic adenocarcinoma (PA). Preoperative embolization (PEA) of the rRHA has been proposed to avoid the onset of postoperative biliary and ischemic liver complications.

Methods: Eighteen patients with cephalic PA with an rRHA underwent PEA of the rRHA from 2013 to 2019. Read More

Diagnostics (Basel) 2021 Apr 15;11(4). Epub 2021 Apr 15.

Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Sq., 603950 Nizhny Novgorod, Russia.

Introduction: Despite the introduction of increasingly multifaceted diagnostic techniques and the general advances in emergency abdominal and vascular surgery, the outcome of treatment of patients with acute impaired intestinal circulation remains unsatisfactory. The non-invasive and high-resolution technique of optical coherence tomography (OCT) can be used intraoperatively to assess intestine viability and associated conditions that frequently emerge under conditions of impaired blood circulation. This study aims to demonstrate the effectiveness of multimodal (MM) OCT for intraoperative diagnostics of both the microstructure (cross-polarization OCT mode) and microcirculation (OCT angiography mode) of the small intestine wall in patients with acute mesenteric ischemia (AMI). Read More

Clinics (Sao Paulo) 2021 26;76:e2683. Epub 2021 Apr 26.

Departamento de Farmacologia, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, Sao Paulo, SP, BR.

Objectives: Ischemia and reperfusion (I/R) in the intestine could lead to severe endothelial injury, compromising intestinal motility. Reportedly, estradiol can control local and systemic inflammation induced by I/R injury. Thus, we investigated the effects of estradiol treatment on local repercussions in an intestinal I/R model. Read More

Medicine (Baltimore) 2021 Apr;100(17):e25700

Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Rationale: Postoperative atrial fibrillation following noncardiac surgery increases mortality, length of hospital stay, and medical expenses; moreover, compared to nonvalvular atrial fibrillation, it poses a similar risk of thromboembolic complications. In this report, we discuss our decision-making process for diagnosis and treatment in case with unexpected postoperative new-onset atrial fibrillation causing acute mesenteric ischemia.

Patient Concerns: A 78-year-old male patient received varicose vein stripping and ligation in his right leg. Read More

Prog Cardiovasc Dis 2021 Mar-Apr;65:71-75. Epub 2021 Apr 24.

Department of Cardiovascular Diseases, The John Ochsner Heart and Vascular Institute, The Ochsner Clinical School, University of Queensland, Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, LA 70121, United States of America. Electronic address:

Chronic mesenteric ischemia (CMI) is an uncommon, potentially underdiagnosed clinical condition. Although there is a high prevalence of mesenteric artery stenoses (MAS), an abundant collateral network in the mesenteric circulation mitigates occurrence of ischemia. The most common etiology of CMI is atherosclerosis. Read More

Surg Today 2021 Apr 23. Epub 2021 Apr 23.

Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima, 890-8520, Japan.

Purpose: To investigate the drainage patterns of the inferior mesenteric vein (IMV) and measure the distance from the root of the inferior mesenteric artery (IMA) to the IMV using preoperative three-dimensional computed tomography (3D-CT) angiography in patients undergoing surgery for left-sided colorectal cancer.

Methods: In this retrospective study, we analyzed data collected prospectively on 167 consecutive patients who underwent laparoscopic left-sided colorectal cancer surgery between July, 2014 and August, 2019. The drainage pattern of the IMV and the distance from the root of the IMA to the IMV were evaluated using 3D-CT angiography. Read More

Ulus Travma Acil Cerrahi Derg 2021 May;27(3):278-283

Department of General Surgery, Üsküdar Anadolu Hospital, İstanbul-Turkey.

Background: Acute mesenteric ischemia (AMI), although relatively rare, is an emergency condition with high mortality rates (60-80%) attributed to lack of early diagnosis. The aim of this experimental study was to observe the changes in serum intestinal fatty acid-binding protein (I-FABP) levels over time in the AMI model by ligating superior mesenteric artery (SMA) in rats and to compare with the serum I-FABP levels of the rats in the control group.

Methods: Twenty rats were randomly allocated into two groups as control and ischemia group. Read More

BMJ Case Rep 2021 Apr 21;14(4). Epub 2021 Apr 21.

Department of Pediatrics, Mercer University School of Medicine, Macon, Georgia, USA.

Gastroschisis is an uncommon congenital defect of the abdominal wall resulting in intestinal prolapse, most commonly associated with short gut syndrome or bowel obstruction. Wandering spleen, movement of the spleen due to the underdevelopment of splenic ligaments, has a prevalence of 0.25% and is asymptomatic in 15% of paediatric cases. Read More

Eur J Radiol 2021 Jun 15;139:109720. Epub 2021 Apr 15.

Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8602, Japan. Electronic address:

Am J Case Rep 2021 Apr 13;22:e929538. Epub 2021 Apr 13.

Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia" - Radiology Unit I, University Hospital "Policlinico-San Marco", Catania, Italy.

BACKGROUND Spontaneous isolated dissection of the superior mesenteric artery (SID-SMA) is a rare but potentially fatal condition. Although many cases of SID-SMA have been reported in the literature in recent years because of the increased use of contrast-enhanced computed tomography (CT) scanning, optimal management has not yet been firmly established. CASE REPORT We report 2 cases of SID-SMA that were managed with stenting and angioplasty via transfemoral access. Read More

Front Pharmacol 2021 25;12:617165. Epub 2021 Mar 25.

Departments of Cardiology and Clinical Pharmacy, Harbin Medical University Cancer Hospital, Institute of Metabolic Disease, Heilongjiang Academy of Medical Science, Heilongjiang key laboratory for Metabolic disorder and cancer related cardiovascular diseases, and Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, China.

Antiangiogenic tyrosine kinases inhibitors induce hypertension, which may increase the incidents of cardiovascular complications and limit their use. However, the mechanisms by which usage of TKIs results in hypertension have not been fully understood. Here, we report the potential mechanisms of how sunitinib, a widely used TKI, induces hypertension. Read More