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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

BMJ Case Rep 2021 Jun 4;14(6). Epub 2021 Jun 4.

General Surgery Department, Koç University Hospital, Istanbul, Turkey.

A 59-year-old man with abdominal pain was admitted to the emergency department. Investigations had revealed a right-sided paraduodenal hernia and superior mesenteric vein (SMV) twisting around the superior mesenteric artery in rotation, the 'whirlpool sign'. Owing to the increasing severity of abdominal pain and the presence of SMV thrombosis complicated with strangulated paraduodenal herniation associated with high mortality rates, diagnostic laparoscopy was performed. 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

J Vis Exp 2021 04 8(170). Epub 2021 Apr 8.

Department of Emergency Surgery, Università Cattolica del S. Cuore.

The superior mesenteric artery can be cannulated in humans through minimally invasive radiological catheterization of the femoral or axillary artery. SMA cannulation is more difficult in rats due to small anatomical dimensions. The aim of the study is to describe a surgical technique for cannulation of the SMA in rats to perform long-term infusion of drugs into the SMA vascular bed in unrestricted animals, which will result in a high rate of catheter patency after the post surgical recovery for 24 hours. Read More

Am J Case Rep 2021 Apr 12;22:e931114. Epub 2021 Apr 12.

Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.

BACKGROUND Protein-losing enteropathy as a complication of superior mesenteric artery occlusion is extremely rare and severe, and sometimes requires intestinal resection. However, the ideal treatment strategy has not yet been determined. CASE REPORT A 77-year-old man with underlying hypertension and diabetes was admitted to the Emergency Department with acute abdominal pain after eating. Read More

Cardiovasc Intervent Radiol 2021 Jul 6;44(7):1030-1038. Epub 2021 Apr 6.

Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.

Purpose: To determine 30-day-mortality rates and identify predictors for survival in patients undergoing endovascular revascularization for acute mesenteric ischemia (AMI) due to occlusion of the celiac (CA) or superior mesenteric artery (SMA) from arterial thrombosis in the setting of atherosclerosis at the vessel origin.

Materials And Methods: A retrospective analysis on patients who underwent acute endovascular revascularization to treat AMI caused by thrombotic occlusion of the CA and/or SMA between January 2011 and December 2019 was conducted. 30-day-mortality rates were calculated. Read More

J Cardiothorac Surg 2021 Mar 30;16(1):61. Epub 2021 Mar 30.

Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou, 64600, Sichuan, China.

Background: To evaluate the role of multi-slice spiral computed tomography (MSCT) angiography in the diagnosis of spontaneous isolated visceral artery dissection (SIVAD).

Methods: Twenty-seven patients with abdominal SIVAD were included in the study. The MSCT scans of the patients were subjected to various post-processing techniques to visualize the visceral artery wall. Read More

Clin J Gastroenterol 2021 Jun 27;14(3):769-775. Epub 2021 Mar 27.

Department of Surgical Oncology, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.

We report a successful case that offered a symbolic therapeutic experience of interventional radiology and surgery collaboration for superior mesenteric artery thrombosis. A 70-year-old man presented with a chief complaint of sudden abdominal pain. Contrast-enhanced computed tomography revealed superior mesenteric artery thrombosis. Read More

Ann Transl Med 2021 Feb;9(4):337

Department of Gastrointestinal Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.

Background: Mesenteric ischemia results in blood flow that is insufficient to meet metabolic demands and subsequent dysfunction of visceral organs, including arterial obstruction and venous thrombosis. Sustained mesenteric ischemia exhausts the ability of capillaries to provide oxygen and initiate an inflammatory reaction, and eventually leads to intestinal mucosal necrosis, a serious and potentially life-threatening condition. Therefore, it is essential that the predictors and risk factors for intestinal necrosis in patients with mesenteric thrombus are explored. Read More

J Vasc Surg 2021 Mar 6. Epub 2021 Mar 6.

Service de chirurgie Vasculaire et Thoracique, Hôpital Bichat, Hôpital Beaujon, AP-HP, Université de Paris, Paris, France; Structure d'Urgences Vasculaire Intestinale (SURVI), Hôpital Beaujon, AP-HP, Université de Paris, Paris, France.

Objective: Despite the continuing controversy of covered stents (CS) vs bare metal stents, the use of CS in mesenteric occlusive disease (MOD) has been recommended by expert centers. The aim of this study was to report midterm results with CS of the superior mesenteric artery.

Methods: Between January 2014 and October 2019, patients with MOD with a severe atheromatous stenosis or occlusion of the superior mesenteric artery treated by mesenteric CS were included. Read More

Plast Reconstr Surg Glob Open 2021 Feb 15;9(2):e3423. Epub 2021 Feb 15.

Department of Dermatology, Yamaguchi University Graduate School of medicine, Ube, Japan.

Celiac artery (CA) occlusion, or stenosis, is not uncommon, and most cases are asymptomatic. If the CA is occluded, collateral circulation from the superior mesenteric artery (SMA) is maintained through the pancreaticoduodenal arcade. However, the pancreaticoduodenal arcade is removed if pancreaticoduodenectomy (PD) is performed, which results in ischemia of the liver, stomach, and residual pancreas. Read More

Eur Rev Med Pharmacol Sci 2021 Feb;25(3):1680-1683

Interventional Radiology Unit, Department of Biomedicine and Prevention, University Hospital Policlinico Tor Vergata, Rome Italy.

Objective: Although pulmonary involvement represents the primary and most characteristic presentation of Sars-Cov-2 infection, due to its innate tropism for endothelium, it is also associated with systemic pro-coagulative changes and thromboses. This paper describes a COVID-19 atypical presentation with massive thrombotic occlusion of the splenoportal-mesenteric axis and the splenic artery in the absence of clinical or radiological manifestation of pulmonary involvement.

Patients And Methods: Female patient, with no history of disease, trauma or fever in the last 30 days, was admitted to ER for persistent left subcostal pain. Read More

J Vasc Surg Cases Innov Tech 2021 Feb 19. Epub 2021 Feb 19.

Division of Vascular Surgery, Department of Surgery, Stony Brook University NY.

Since the emergence of novel coronavirus pneumonia (NCP), a number of reports have pointed out an increased coagulation activity in these patients mostly during acute phase of the disease. We are reporting a case of acute superior mesenteric thrombosis in a 55-year-old male with NCP one week after hospital discharge. He returned to the emergency department 7 days later with severe acute abdominal pain and found to have superior mesenteric artery thrombosis. Read More

J Vasc Interv Radiol 2021 05 19;32(5):703-711. Epub 2021 Feb 19.

Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, P.R. China. Electronic address:

Purpose: To evaluate the safety and efficacy of false lumen (FL) stent-grafts in the treatment of postdissection aortic aneurysms.

Materials And Methods: Eleven patients who underwent endovascular repair using FL stent-grafts from January 2016 to June 2019 were included. Among them, 2 patients had a prior history of type A aortic dissection, whereas 9 had undergone a prior endovascular repair for type B aortic dissection. Read More

J Emerg Med 2021 05 5;60(5):e103-e107. Epub 2021 Jan 5.

Department of Emergency Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.

Background: Patients with coronavirus disease 2019 (COVID-19) commonly present with fever, constitutional symptoms, and respiratory symptoms. However, atypical presentations are also well known. Though isolated mesenteric arterial occlusion associated with COVID-19 has been reported in literature, combined superior mesenteric arterial and venous thrombosis is rare. Read More

World J Transplant 2021 Jan;11(1):1-6

Department of General and Digestive Surgery, Reina Sofia University Hospital, Cordoba 14004, Spain.

To describe the main aspects of back-table surgery in pancreatic graft and the problems arising from poor technique. Back-table surgery for pancreatic graft is a complex, meticulous and laborious technique on which the success of implant surgery and perioperative results depends. The technique can be described in the following steps: Preparation of the sterile table, inspection of the pancreas-spleen block, management of the duodenum, identification of the bile duct, preparation of the portal vein, preparation of the own graft arteries and anastomosis to the arterial graft, spleen management and graft preservation prior to implantation in the recipient. Read More

J Vasc Surg 2021 Feb 4. Epub 2021 Feb 4.

Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

Objective: Despite its association with static mesenteric malperfusion, the morphologic characteristics and optimal management of acute type B aortic dissection (ABAD) with superior mesenteric artery (SMA) involvement are poorly understood. We studied the associated risk factors and reported the outcomes of endovascular treatment.

Methods: From May 2016 to May 2018, we examined 212 consecutive patients with ABAD in our center. Read More

J Postgrad Med 2021 Jan-Mar;67(1):39-42

Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.

An elderly hypertensive lady presented with fever, respiratory symptoms, and mild abdominal discomfort and was diagnosed to have COVID-19 pneumonia. Respiratory symptoms improved with steroids, awake proning, high flow nasal cannula oxygen therapy and antibiotics. After 4 days, she developed non-occlusive superior mesenteric artery thrombosis, which initially responded to anticoagulants but was complicated on tenth day by intestinal obstruction necessitating emergency surgery. Read More

Ann Vasc Surg 2021 May 4;73:397-406. Epub 2021 Jan 4.

Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

Background: Juxta-renal (JAAA)/para-renal (PAAA) and type IV-thoracoabdominal (TAAA) aneurysms can be repaired by custom-made fenestrated endografts (CM-FEVAR). Differently from open repair, a relatively long segment of healthy proximal aorta needs to be covered to achieve a durable sealing, and this may be considered a disadvantage of the endovascular approach. We aimed to quantify the additional proximal aortic coverage in JAAAs, PAAAs, and type-IV TAAAs treated with CM-FEVAR and to evaluate its impact on early/follow-up clinical outcomes. Read More

Clin Rheumatol 2021 Jul 3;40(7):3001-3006. Epub 2021 Jan 3.

Chaim Sheba Medical Center The Zabludowicz Center for Autoimmune Diseases Tel Hashomer, Ramat Gan, Israel.

To perform a review on patients with primary antiphospholipid syndrome (APS) who developed an aneurysm. A review of articles published in PubMed/MEDLINE, LILACS, and SciELO dating from 1966 to October 2020 was conducted using the following search words: "Antiphospholipid syndrome" and "aneurysm." No language limitation was applied. Read More

Vet Parasitol Reg Stud Reports 2020 12 6;22:100478. Epub 2020 Oct 6.

Department of Parasitology, Faculty of Veterinary Medicine, University of Sadat City, Sadat City 32511, Minoufiya, Egypt.

Strongylus vulgaris has high pathogenicity to equines. It causes aneurysm and thrombosis in the arteries particularly an anterior mesenteric artery, that is fatal to equines. In this study, we aimed to diagnose microscopically the natural infection of donkeys with Strongylus vulgaris from Sadat City, Minoufiya Governorate, Egypt. Read More

Clin Imaging 2021 Apr 14;72:178-182. Epub 2020 Nov 14.

Department of Radiology, Columbia University Irving Medical Center, New York, NY, United States of America.

Background: Thrombotic complications of COVID-19 infection have become increasingly apparent as the disease has infected a growing number of individuals. Although less common than upper respiratory symptoms, thrombotic complications are not infrequent and may result in severe and long-term sequelae. Common thrombotic complications include pulmonary embolism, cerebral infarction, or venous thromboembolism; less commonly seen are acute myocardial injury, renal artery thrombosis, and mesenteric ischemia. Read More

HPB (Oxford) 2021 Apr 4;23(4):483-494. Epub 2020 Dec 4.

Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Background: Contemporary practice for superior mesenteric/portal vein (SMV-PV) reconstruction during pancreatectomy with vein resection involves biological (autograft, allograft, xenograft) or synthetic grafts as a conduit or patch. The aim of this study was to systematically review the safety and feasibility of the different grafts used for SMV-PV reconstruction.

Methods: A systematic search was performed in PubMed and Embase according to the PRISMA guidelines (January 2000-March 2020). Read More

Cureus 2020 Nov 4;12(11):e11326. Epub 2020 Nov 4.

Anaesthesia and Intensive Care, Military Hospital, Milan, ITA.

Coronavirus disease 2019 (COVID-19) in humans is a novel disease that can affect every organ of the body, with life-threatening consequences. Microvascular lesions and thrombosis have been previously reported in the lung, kidney, and brain. We report a case of combined intestinal lesions and Guillain-Barrè Syndrome in a patient suffering from COVID-19 in the absence of clear laboratory predictors of upcoming complications. Read More

Asian J Surg 2021 Mar 28;44(3):549-552. Epub 2020 Nov 28.

Intestinal Rehabilitation Team, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea; Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea.

Background: Type II (acute) intestinal failure (IF) is usually caused by complications of abdominal surgery resulting in enteric fistulas or proximal stomas and requires parenteral nutrition (PN) for several months. This study aimed to evaluate clinical management and outcome of type II IF patients in a single center.

Methods: Medical records of patients referred to the Intestinal Rehabilitation Team (IRT) at Samsung Medical Center (Seoul, Korea) were retrospectively analyzed. Read More

Heart Surg Forum 2020 Oct 8;23(6):E718-E724. Epub 2020 Oct 8.

Department of Cardiovascular Surgery, The health science university, Elazig Research and Training Hospital, Elazig, Turkey.

Background: The modified systemic to pulmonary artery shunt (mSPS) is an effective palliative procedure in children with cyanotic congenital heart disease (CCHD) who are not suited for total correction. Early graft failure related to hereditary thrombophilic disorder is one cause of mortality. The aim of this study is to compare the clinical outcomes and rate of graft failure after mSPS in cyanotic infants with hereditary thrombophilia using bovine mesenteric venous graft (BMVG) and polytetrafluoroethylene (PTFE). Read More

Abdom Radiol (NY) 2020 Nov 23. Epub 2020 Nov 23.

Department of Radiology, Aster CMI Hospital, Airport Road, Bangalore, 560092, India.

Mesenteric ischemia is a broad term encompassing several clinical conditions leading to impaired vascularity of bowel loops. Absence of specific clinical presentation and a definitive laboratory marker often lead to delayed diagnosis with high morbidity and mortality in the acute setting. Imaging plays a crucial role in the diagnosis and management. Read More

Saudi J Kidney Dis Transpl 2020 Sep-Oct;31(5):1129-1133

Department of Nephrology, Military Hospital of Tunisia, Monfleury, Tunis, Tunisia.

The nutcracker syndrome (NCS) is a rare condition characterized by the entrapment of the left renal vein between the superior mesenteric artery and the aorta. Clinically, it presents with hematuria, flank pain, and symptoms of pelvic venous congestion. It is more frequent in females. Read More

World J Surg 2020 Nov 22. Epub 2020 Nov 22.

Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Loyola University Medical Center, 2160 S. First Ave, EMS Building 110, Room 3213, Maywood, IL, 60153, USA.

Introduction: The past 25 years have been witness to a revolution in how vascular care is delivered. The majority of arterial and venous interventions have converted from open surgery to minimally invasive percutaneous endovascular procedures.

Methods: This surgical innovations symposium article reviews current endovascular therapy in multiple vascular beds with a primary focus on carotid artery occlusive disease, aortic pathologies, and lower extremity arterial occlusive disease. Read More

Int J Surg Case Rep 2020 11;77:454-458. Epub 2020 Nov 11.

Vascular Surgery, Hospital Monte Sinai and Unimed Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Electronic address:

Introdution: COVID-19 infection may predispose to venous and arterial thromboembolism due to excessive inflammation, hypoxia, immobilization and disseminated intravascular coagulation; however, there are few reports of lower limb ischemia as the main manifestation of the disease.

Presentation Of Case: Male patient, 69 years old, asthmatic, ex-smoker and bearer of systemic arterial hypertension, has been admitted to the emergency department with sudden onset of pain in the right lower limb (RLL), associated with cyanosis and reduced temperature of the limb. He has been tested for COVID-19 in the OR with positive result for IGG and IGM. Read More