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Biomed Pharmacother 2022 Jun 22;153:113320. Epub 2022 Jun 22.

Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Acute mesenteric ischemia is known as a life threatening condition. Re-establishment of blood flow in this condition can lead to mesenteric ischemia reperfusion (MIR) injury which is accompanied by inflammatory response. Still, clear blueprint of inflammatory mechanism underlying MIR injury has not been provided. Read More

Inflammation 2022 Jun 14. Epub 2022 Jun 14.

Department of Anesthesiology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Ave N, Guangzhou, 510515, China.

Liver injury induced by intestinal ischemia/reperfusion (I/R) is accompanied by the polarization of Kupffer cells, which are specialized macrophages located in the liver. However, the causes of hepatic macrophage polarization after intestinal I/R remain unknown. This study investigated whether gut-derived exosomes contribute to the pathogenesis of liver injury triggered by intestinal I/R in a murine model and explored the underlying mechanisms. Read More

Cureus 2022 May 8;14(5):e24819. Epub 2022 May 8.

Internal Medicine, Jersey City Medical Center, Jersey City, USA.

Although isolated superior mesenteric artery dissection is a rare disease entity, it possesses high mortality. The pathophysiology remains a mystery. In this case, we report a 68-year-old male with compromised coronary circulation been evaluated for coronary artery bypass surgery (CABG) and who developed a sudden, localized, right-sided abdominal pain. Read More

Cureus 2022 May 5;14(5):e24761. Epub 2022 May 5.

Emergency and Critical Care Center, Kurashiki Central Hospital, Kurashiki, JPN.

A 67-year-old man developed an abdominal aortic aneurysm (AAA) and Stanford type B acute aortic dissection. He received liberal antihypertensives for complicated spinal cord ischemia and, subsequently, experienced loss of appetite, followed by vomiting without abdominal pain. Computed tomography revealed AAA expansion and compression of the duodenum between the superior mesenteric artery (SMA) and AAA. Read More

BMC Surg 2022 Jun 3;22(1):214. Epub 2022 Jun 3.

Second Affiliated Hospital of Soochow University, Suzhou, China.

Background: Nonocclusive mesenteric ischemia (NOMI) is defined as acute intestinal ischemia because of decreased blood flow in mesenteric vessels. Only a few cases of NOMI that occur secondary to aortic dissection (AD) have been reported, resulting in the lack of sufficient knowledge of diagnosis and treatment.

Case Presentation: We aimed to report a case of NOMI caused by type B Aortic Dissection. Read More

Ann Vasc Surg 2022 May 30. Epub 2022 May 30.

Division of Vascular and Endovascular Surgery, Department of Surgery, New York University Langone Medical Center, New York, NY. Electronic address:

Background: Potential complications of pelvic flow disruption during aortic aneurysm repair include buttock ischemia and mesenteric ischemia. Unilateral or bilateral hypogastric artery flow interruption, either from atherosclerosis or intentionally to facilitate aneurysm repair, is considered problematic in endovascular repair; however, it has not been well studied in open abdominal aortic aneurysm (AAA) repair (OAR). We sought to examine the effect of interruption of flow to one or both hypogastric arteries on outcomes after OAR. Read More

Radiol Case Rep 2022 Jul 20;17(7):2568-2572. Epub 2022 May 20.

Department of Radiological Sciences, Oncology and Pathology, "Sapienza" University of Rome - I.C.O.T. Hospital, Via Franco Faggiana, 1668, 04100, Latina, Italy.

Acute Mesenteric Ischemia (AMI) is a rare life-threatening entity caused by sudden interruption of the blood supply to a segment of the bowel due to impairment of mesenteric arterial blood flow or venous drainage. Clinical presentation varies according to the time course of vascular occlusion. Contrast-enhanced Computed Tomography (CT) of the abdomen represents the main diagnostic test for AMI diagnosis, enabling fast and excellent evaluation of the intestine, mesenteric vasculature, and other ancillary characteristics of AMI. Read More

Int J Mol Sci 2022 May 16;23(10). Epub 2022 May 16.

MITOVASC, Equipe CarMe, CNRS 6015, Inserm 1083, Angers Université, 49100 Angers, France.

Hypoxia and inflammation play a major role in revascularization following ischemia. Sildenafil inhibits phosphodiesterase-5, increases intracellular cGMP and induces revascularization through a pathway which remains incompletely understood. Thus, we investigated the effect of sildenafil on post-ischemic revascularization. Read More

Kyobu Geka 2022 Jun;75(6):411-415

Department of Cardiovascular Surgery, Japanese Red Cross Nagaoka Hospital, Nagaoka, Japan.

A 52-year-old man developed Stanford type A acute aortic dissection and suffered severe pain in the back and the chest, and numbness of the left lower limb. Contrast-enhanced computed tomography (CT) revealed occlusion of the left iliac artery due to dissection. The celiac artery was also obstructed and the superior mesenteric artery was severely narrowed, but there was no clear sign of organ ischemia. Read More

Int Immunopharmacol 2022 Jul 18;108:108852. Epub 2022 May 18.

Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, PR China. Electronic address:

Isoliquiritin apioside (IA), a critical ingredient of Glycyrrhizae radix et rhizoma, has been unveiled to possess remarkable pharmacological activity against oxidative stress and inflammation. However, the potential roles of IA in intestinal ischemia/reperfusion (I/R)-induced acute lung injury (ALI) have not been reported yet. In the present study, we explored the effects of IA on I/R-induced ALI, and also clarified the possible mechanisms. Read More

Ann Vasc Surg 2022 May 17. Epub 2022 May 17.

Advanced Endovascular Aortic Research Program, Mayo Clinic, Rochester, MN. Electronic address:

Background: To evaluate outcomes following urgent or emergent fenestrated-branched endovascular aortic repair (F-BEVAR) for pararenal (PRA) and thoracoabdominal aortic aneurysms (TAAA) in patients who are considered high-risk for open repair.

Methods: A retrospective, single institution evaluation of outcomes following F-BEVAR of symptomatic, rapidly enlarging, or ruptured PRA or TAAA treated with physician modified endograft (PMEG) and company manufactured devices (CMD). Outcomes were technical success, 30-day morbidity and mortality, and 1 year aortic related outcomes. Read More

Clin Med (Lond) 2022 05;22(3):282-284

Wexham Park Hospital, Slough, UK

A 60-year-old woman presented with sudden-onset epigastric pain, vomiting and small volume rectal bleeding. She had a history of mechanical mitral valve replacement, for which she was on warfarin. Computed tomography (CT) angiography of the abdomen showed gallstones, a fluid-filled stomach and faecal loading. Read More

BMC Med Imaging 2022 May 16;22(1):90. Epub 2022 May 16.

Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.

Background: Endovascular revascularization has become the first-line treatment of chronic mesenteric ischemia (CMI). The qualitative visual analysis of digital subtraction angiography (DSA) is dependent on observer experience and prone to interpretation errors. We evaluate the feasibility of 2D-Perfusion Angiography (2D-PA) for objective, quantitative treatment response assessment in CMI. Read More

Gastroenterology Res 2022 Apr 12;15(2):100-105. Epub 2022 Mar 12.

Department of Internal Medicine, Saint Francis Presence Hospital, Evanston, IL, USA.

Venous thromboembolism (VTE) is a recognized extraintestinal manifestation of inflammatory bowel disease (IBD), with deep venous thrombosis (DVT) and pulmonary embolism being reported as the most frequent vascular complications in IBD patients. Much less frequently, arterial thromboembolic events may also be associated with greater morbidity and mortality. Aortic mural thrombosis is a rare phenomenon described in patients with IBD that often results in serious consequences such as visceral infarction and acute ischemia of the lower extremities. Read More

Rev Esp Enferm Dig 2022 May 12. Epub 2022 May 12.

Aparato Digestivo, Hospital Royo Villanova, España.

A 74-year-old patient presented to our emergency department with melena for 24 hours, associated with postprandial abdominal pain, predominantly in the epigastrium, for one month. Urgent gastroscopy showed a pale mucosa with loss of vascular pattern in the gastric antrum, as well as several superficial ulcers, Forrest III, at that level and in the duodenal bulb highly suggestive of ischaemia. An abdominal computed tomography angiography (CTA) revealed a filiform celiac trunk, with calcified atherosclerotic plaques in the ostium, superior mesenteric artery and both renal arteries, with absence of enhancement in a large part of the intestinal wall, suggestive of ischaemia. Read More

Can Assoc Radiol J 2022 May 11:8465371221094280. Epub 2022 May 11.

Department of Diagnostic Radiology, 8664University of Manitoba, Winnipeg, MB, Canada.

Acute mesenteric ischemia (AMI) is an uncommon yet highly lethal cause of acute abdomen in the emergency setting. Computed tomography (CT) imaging, in particular a biphasic protocol consisting of angiographic and venous phase scans, is widely used to corroborate non-specific clinical findings when suspicions of AMI are high. Techniques such as low kilovoltage peak scanning, dual energy acquisition, or a combined arterial/enteric phase can improve iodine conspicuity and evaluation of bowel enhancement. Read More

Cureus 2022 Apr 27;14(4):e24532. Epub 2022 Apr 27.

Coronary Care Unit, National Institute of Cardiology, Mexico City, MEX.

Infective endocarditis (IE) can be complicated by systemic embolization. Unfortunately, in some situations, it requires radical and urgent therapeutic approaches. Herein, we describe a case of IE complicated by acute mesenteric ischemia (AMI) due to septic embolism prior to emergent cardiac surgery. Read More

Eur J Vasc Endovasc Surg 2022 Apr 25. Epub 2022 Apr 25.

Institute of Clinical Medicine, University of Tartu, Tartu, Estonia; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. Electronic address:

Cureus 2022 Apr 18;14(4):e24251. Epub 2022 Apr 18.

General Surgery Department, Imam Abdulrahman Alfaisal Hospital, Riyadh, SAU.

Introduction Superior mesenteric artery syndrome (SMAS), also called mesenteric duodenal compression syndrome, Wilkie's syndrome, chronic duodenal ileus or cast syndrome, is a rare clinical condition defined as a compression of the third portion of the duodenum in between the SMA and abdominal aorta (AA), due to narrowing of the space between them. SMAS is primarily attributed to loss of the intervening mesenteric fat pad, leading to partial or complete duodenal obstruction. Its manifestations are complex and non-specific, including postprandial epigastric pain, nausea, vomiting, early satiety, weight loss and anorexia. Read More

J Thorac Cardiovasc Surg 2022 Mar 26. Epub 2022 Mar 26.

Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan.

Objectives: We aimed to examine the incidence, etiologies, and consequences of acute mesenteric ischemia as well as the impact of preprocedural subclinical mesenteric artery stenosis in patients undergoing transcatheter aortic valve replacement.

Methods: Among prospective follow-up of 269 consecutive patients undergoing transcatheter aortic valve replacement, diagnosis of acute mesenteric ischemia was confirmed by abdominal computed tomography. Cumulative hazard of 1-year all-cause and cardiovascular mortality according to the absence or presence of mesenteric artery stenosis 70% or greater from preprocedural computed tomography angiography was analyzed. Read More

Cureus 2022 Mar 9;14(3):e23013. Epub 2022 Mar 9.

Internal Medicine, Centro Hospitalar Tâmega e Sousa, Penafiel, PRT.

The coronavirus disease 2019 (COVID-19) disease is a multisystem disease and recent studies have shown an increase in reported thromboembolic complications as deep venous thrombosis, pulmonary embolism (PE), stroke, and less frequently mesenteric artery thrombosis. We present a case of a 75-year-old woman, COVID-19 positive with five days of evolution, who was admitted to the emergency room due to diffuse abdominal pain with several days of progression, along with diarrhea and biliary vomit. Abdominal computed tomography presented images of subtraction of the lumen of the upper mesenteric artery. Read More

Acta Radiol Open 2022 Apr 18;11(4):20584601221094826. Epub 2022 Apr 18.

Department of Radiology, Rigshospitalet, Copenhagen, Denmark.

In this case report, we outline a tailored approach for a complex patient with acute in chronic proximal occlusive mesenteric disease complicated with fresh thrombosis and a heavily calcified aorta, where the standard treatment proved suboptimal. We outline the surgical considerations that ultimately led to performing a hybrid procedure of open thrombectomy combined with retrograde open mesenteric stenting of the superior mesenteric artery. The patient was a 75-year-old male, with a history of severe arteriosclerosis presenting with abdominal pain over 48 h. Read More

Int J Surg Case Rep 2022 May 18;94:107088. Epub 2022 Apr 18.

Department of Surgery, Shinko Hospital, 1-4-47 Wakihama-cho, Chuo-ku, Kobe City, Hyogo 651-0072, Japan.

Introduction: Evaluation of anatomical variations is important in pancreatoduodenectomy (PD) because an arterial anomaly is a risk factor for morbidity. Herein, we report a rare case of PD for lower bile duct cancer in which celiac axis stenosis and a replaced common hepatic artery (rCHA) coexisted.

Presentation Of Case: An 84-year-old woman presented with epigastric pain. Read More

Dis Mon 2022 Apr 18:101367. Epub 2022 Apr 18.

Kasturba Hospital, Kasturba Medical College, Manipal, Udupi, Karnataka 576104, India.

Ann R Coll Surg Engl 2022 Apr 21. Epub 2022 Apr 21.

Liverpool University Hospitals NHS Foundation Trust, UK.

Collateralisation around stenotic or occlusive arterial disease is a commonly observed adaptation for maintenance of arterial perfusion. It occurs through pathways of well-understood embryological origin. Examples include Winslow's pathway (internal thoracic artery to iliac artery via the epigastric arteries) and the arc of Riolan (between superior and inferior mesenteric arteries). Read More

Eur J Radiol 2022 Jun 12;151:110316. Epub 2022 Apr 12.

Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Purpose: The physiological increase of mesenteric blood flow after a meal is impaired in patients with occlusive chronic mesenteric ischemia (CMI). This principle could be used to develop a highly desired diagnostic test assessing the sufficiency of the collateral mesenteric circulation. This study assesses the potential to identify CMI patients using two-dimensional time-resolved phase-contrast magnetic resonance imaging (2D PC-MRI) flow measurements. Read More

Ann Vasc Dis 2022 Mar;15(1):1-7

Division of Vascular & Endovascular Surgery, Department of Surgery, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.

Isolated superior mesenteric artery dissection (ISMAD) is a rare pathology with multifactorial etiology. The aim of this article is to provide a narrative review of the latest literature about ISMAD. Case reports, series, and recent meta-analyses were included. Read More

Ann Vasc Dis 2022 Mar;15(1):68-71

First Department of Surgery, University of Toyama, Toyama, Toyama, Japan.

Takayasu arteritis is an inflammatory disease of the aorta and its major branches, which results in stenosis and aneurysm formation. Lesions of the abdominal aorta and renal arteries are common. Nevertheless, lesions of the celiac and superior mesenteric arteries are less common. Read More

Vasc Health Risk Manag 2022 8;18:233-243. Epub 2022 Apr 8.

Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Ullevål, Oslo, Norway.

Introduction: Due to diagnostic delay, chronic mesenteric ischemia (CMI) is underdiagnosed. We assumed that the patients suspected of CMI of the atherosclerotic origin or median arcuate ligament syndrome (MALS) could be identified earlier with endoscopic duplex ultrasound (E-DUS).

Patients And Methods: Fifty CMI patients with CTA-verified stenosis of either ≥50% and ≥70% of celiac artery (CA) and superior mesenteric artery (SMA) were examined with E-DUS and transabdominal duplex ultrasound (TA-DUS). Read More

Georgian Med News 2022 Mar(324):170-175

3Pyatigorsk Medical and Pharmaceutical Institute - a branch of Federal State Budgetary Educational Institution of Higher Education " Volgograd State Medical University" of the Ministry of Healthcare of Russia.

The purpose of the work was to analyze the pro-inflammatory reaction caused by different duration of ischemic-reperfusion of intestinal damage in occlusion of anterior mesenteric artery in the experiment. Ischemic reperfusion damage of the intestinal wall was simulated using reversible occlusion of the anterior mesenteric artery with 30 rats. Two types of operations were carried out: operation 1 - the duration of ischemia 20 minutes, reperfusion - 40 minutes, operation 2 - 30 and 30 minutes, respectively. Read More