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    Portal vein thrombosis in patients with cirrhosis.
    Gastroenterol Rep (Oxf) 2017 May 24;5(2):148-156. Epub 2017 Apr 24.
    Department of Internal Medicine I, University of Bonn, Bonn, Germany.
    Portal vein thrombosis (PVT) is frequent in patients with liver cirrhosis and possible severe complications such as mesenteric ischemia are rare, but can be life-threatening. However, different aspects of clinical relevance, diagnosis and management of PVT are still areas of uncertainty and investigation in international guidelines. In this article, we elaborate on PVT classification, geographical differences in clinical presentation and standards of diagnosis, and briefly on the current pathophysiological understanding and risk factors. Read More

    Undersized Stent Grafts for Acute Mesenteric Ischemia in Chronic Type B Dissection.
    Ann Thorac Surg 2017 Jun;103(6):e501-e503
    Lenox Hill Hospital, Northwell Health, New York, New York.
    Acute ischemia in chronic type B dissections carries high rates of morbidity and mortality. A 29-year-old woman with a chronic type B dissection presented with acute abdominal pain. Imaging revealed a worsening dissection with pseudocoarctation causing near complete occlusion of the true lumen by the false lumen. Read More

    SM22 a Plasma Biomarker for Human Transmural Intestinal Ischemia.
    Ann Surg 2017 May 18. Epub 2017 May 18.
    *Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands †NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands ‡MHeNs School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands §Currently at the Pediatric Surgical Center of Amsterdam, Emma Children's Hospital Academic Medical Center and VU University Medical Center, Amsterdam, the Netherlands.
    Objective: To evaluate the diagnostic potential of smooth muscle protein of 22 kDa (SM22) as plasma biomarker for the detection of transmural intestinal ischemia.

    Background: Acute mesenteric ischemia is an abdominal emergency requiring rapid diagnosis and treatment. Especially, detection of transmural damage is imperative because it mandates emergency surgery. Read More

    [Conservative and surgical ileus treatment].
    Chirurg 2017 May 16. Epub 2017 May 16.
    Klinik für Allgemein‑, Viszeral‑, Gefäss- und Thoraxchirurgie, Klinikum Memmingen, Bismarckstr. 23, 87700, Memmingen, Deutschland.
    The diagnosis ileus is one of the most common indications for an emergency laparotomy. In 70% of the cases, the small intestine is affected, and in 30% it is the colorectum. While stuck hernias are a major cause in developing countries, the most common causes in western countries are postoperative adhesions that lead to an acute bowl obstruction. Read More

    Mangiferin protects against ‭intestinal ischemia/reperfusion-induced ‭liver injury: ‬‬Involvement of PPAR-‭γ, GSK-3β and Wnt/β-catenin pathway‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬.
    Eur J Pharmacol 2017 May 12. Epub 2017 May 12.
    Department of Pharmacology & Toxicology, Cairo University, 11562 Cairo, Egypt.
    Aim: Mangiferin (MF), a xanthonoid from Mangifera indica, possesses anti-inflammatory, immunomodulatory, and potent antioxidant effects; however, its protective effect against mesenteric ischemia/reperfusion (I/R)-induced liver injury has not been fully clarified. The study was designed to assess the possible mechanism of action of MF against mesenteric I/R model.

    Main Methods: Male Wister rats were treated with MF (20mg/kg, i. Read More

    Medical therapy and intervention do not improve uncomplicated isolated mesenteric artery dissection outcomes over observation alone.
    J Vasc Surg 2017 May 12. Epub 2017 May 12.
    Department of Vascular Surgery, University of California, Los Angeles, Calif.
    Objective: Isolated dissection of the mesenteric vessels is rare but increasingly recognized. This study aimed to evaluate patient characteristics, primary treatment, and subsequent outcomes of mesenteric dissection using multi-institutional data.

    Methods: All patients at participant hospitals between January 2003 and December 2015 with dissection of the celiac artery (or its branches) or dissection of the superior mesenteric artery (SMA) were included. Read More

    Primary Volvulus of the Small Intestine Exhibiting Chylous Ascites: A Case Report.
    J Nippon Med Sch 2017 ;84(2):83-86
    Department of Surgery, Saitama Citizens Medical Center.
    Background: Primary volvulus of the small intestine associated with chylous ascites is very rare, with only four reported cases. In this paper, we report a new case of primary volvulus associated with chylous ascites.

    Case Presentation: The patient was a 70-year-old man. Read More

    Attenuation of intestinal ischemia-reperfusion-injury by β-alanine: a potentially glycine-receptor mediated effect.
    J Surg Res 2017 May 27;211:233-241. Epub 2016 Dec 27.
    Institut für Physiologische Chemie, Universitätsklinikum Essen, Universität Duisburg-Essen, Germany.
    Background: Acute mesenteric ischemia is often caused by embolization of the mesenteric arterial circulation. Coherent intestinal injury due to ischemia and following reperfusion get visible on macroscopic and histologic level. In previous studies, application of glycine caused an ameliorated intestinal damage after ischemia-reperfusion in rats. Read More

    Nonocclusive mesenteric infarction after cardiac surgery: potential biomarkers.
    J Surg Res 2017 May 9;211:21-29. Epub 2016 Dec 9.
    Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand.
    Background: Nonocclusive mesenteric ischemia can cause intestinal infarction but the diagnosis is challenging. This prospective study evaluated three plasma biomarkers of intestinal infarction after cardiac surgery.

    Materials And Methods: Patients were recruited after cardiac surgery if they required laparotomy (with or without intestinal resection) for suspected nonocclusive mesenteric ischemia. Read More

    DIFFERENT PROTOCOLS OF POSTCONDITIONING DOES NOT ATTENUATE MESENTERIC ISCHEMIA-REPERFUSION INJURY AFTER SHORT-TERM REPERFUSION.
    Arq Bras Cir Dig 2017 Jan-Mar;30(1):27-29
    Laboratory of Experimental Surgery, Faculty of Medicine, State University of Pará - UEPA, Belém, PA, Brazil.
    Background:: Mesenteric ischemia is a challenging diagnosis. Delay in diagnosis can lead to extent bowel necrosis and poor outcomes. Ischemia and reperfusion syndrome plays an important role in this scenario. Read More

    Retrograde aortomesenteric Bypass with left-retrorenal route - "French Bypass" in 16 cases of chronic mesenteric ischemia.
    Ann Vasc Surg 2017 May 5. Epub 2017 May 5.
    Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße 5, 40225 Düsseldorf. Electronic address:
    Objective: There are several options for treating patients suffering from chronic mesenteric ischemia (CMI). One possibility contains bypass grafting following a left renal route to avoid inter alia kinking of the bypass. This study reviews the results of 16 patients suffering from CMI treated with this bypass technique, called "French Bypass" (FB). Read More

    Severe mesenteric ischemia in a pregnant woman with antiphospholipid syndrome.
    Ann Vasc Surg 2017 May 5. Epub 2017 May 5.
    Vascular and Endovascular Surgery Unit, Department of Public Health, University Federico II of Naples, Naples, Italy. Electronic address:
    The antiphospholipid syndrome (APS), either primary or secondary form, is considered an autoimmune disease with presence of at least one clinical and one laboratory abnormalities as defined by The Sydney criteria. Clinical criteria include vascular thrombosis of venous, artery, small vessel in any organ and recurrent pregnancy pathologies. Mesenteric ischemia is a rare and threatening manifestation of APS. Read More

    Acute mesenteric ischemia and hepatic infarction after treatment of ectopic Cushing's syndrome.
    Endocrinol Diabetes Metab Case Rep 2017 28;2017. Epub 2017 Feb 28.
    Departments of Endocrinology and Metabolism.
    Summary: Patients with Cushing's syndrome and excess exogenous glucocorticoids have an increased risk for venous thromboembolism, as well as arterial thrombi. The patients are at high risk of thromboembolic events, especially during active disease and even in cases of remission and after surgery in Cushing's syndrome and withdrawal state in glucocorticoid users. We present a case of Cushing's syndrome caused by adrenocorticotropic hormone-secreting lung carcinoid tumor. Read More

    Inferior Mesenteric Artery Aneurysm Complicated with Occluded Celiac and Superior Mesenteric Artery after Replacement of Thoracoabdominal Aorta for Chronic Dissected Thoracoabdominal Aortic Aneurysm.
    Ann Vasc Surg 2017 May 4. Epub 2017 May 4.
    Department of Cardiovascular Surgery, Fukushima Medical University, Fukushima, Japan, 1 Hikarigaoka, Fukushima 960-1295, Japan.
    We report a case of inferior mesenteric artery aneurysm after the replacement of the thoracoabdominal aorta for a chronic dissected thoracoabdominal aortic aneurysm in which the celiac artery and superior mesenteric artery were occluded. We performed the resection of the inferior mesenteric artery aneurysm and the revascularization of the superior mesenteric artery, inferior mesenteric artery, and the meandering artery. The patient's postoperative course was uneventful, without bowel ischemia. Read More

    Open and Endovascular Management of Inferior Mesenteric Artery Aneurysms: A Report of Two Cases.
    Ann Vasc Surg 2017 May 4. Epub 2017 May 4.
    Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, 22S. Greene St, Baltimore, MD 21201.
    Inferior mesenteric artery (IMA) aneurysms are a rare entity, attributing to 1% of sphlanic aneurysms, [1] often found incidentally on evaluation for other intra-abdominal pathologies. Similar to other visceral arterial aneurysm, there is an estimated 20-50% risk of potentially fatal rupture and repair is generally recommended. We report two patients with IMA aneurysms, using them as cases to illustrate feasibility of both open and endovascular management options. Read More

    Diagnostic accuracy of novel serological biomarkers to detect acute mesenteric ischemia: a systematic review and meta-analysis.
    Intern Emerg Med 2017 May 6. Epub 2017 May 6.
    Department of Intensive Care Medicine, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP, Ede, The Netherlands.
    Laparotomy remains the gold standard for diagnosis of acute mesenteric ischemia (AMI), but is often unhelpful or too late due to non-specific clinical and radiological signs. This systematic review and meta-analysis aims to evaluate the diagnostic accuracy of the novel serological biomarkers intestinal fatty acid-binding protein (I-FABP), α-glutathione S-transferase (α-GST), D-lactate, ischemia modified albumin (IMA), and citrulline to detect AMI. A systematic search of electronic databases was performed to identify all published diagnostic accuracy studies on I-FABP, α-GST, D-lactate, IMA, and citrulline. Read More

    ACR Appropriateness Criteria(®) Radiologic Management of Mesenteric Ischemia.
    J Am Coll Radiol 2017 May;14(5S):S266-S271
    Panel Chair, University of Chicago Hospital, Chicago, Illinois.
    Mesenteric vascular insufficiency is a serious medical condition that may lead to bowel infarction, morbidity, and mortality that may approach 50%. Recommended therapy for acute mesenteric ischemia includes aspiration embolectomy, transcatheter thrombolysis, and angioplasty with or without stenting for the treatment of underlying arterial stenosis. Nonocclusive mesenteric ischemia may respond to transarterial infusion of vasodilators such as nitroglycerin, papaverine, glucagon, and prostaglandin E1. Read More

    Protection by the EPH-EPHRIN System Against Mesenteric Ischemia-Reperfusion Injury.
    Shock 2017 May 2. Epub 2017 May 2.
    *Food and Drug Department, University of Parma, Parco Area delle Scienze 27/a, 43124 Parma, Italy †Department of Veterinary Sciences, University of Parma, via del Taglio 10, 43126 Parma, Italy.
    Mesenteric ischemia-reperfusion (I/R)-induced injury targets primarily endothelial and epithelial cells, leading to a cascade of inflammatory events, eventually culminating in life-threatening syndromes. Hitherto, the role of Eph, the largest family of tyrosine kinase receptors, and of their cell-bound ephrin ligands, whose interaction generates a bidirectional signaling, is still debated in I/R injury. The aim of the present work was therefore to investigate the effects produced by unidirectional activation of forward signaling (administration of chimeric protein ephrinA1-Fc), of reverse signaling (EphA2-Fc), or inhibition of both signals (monomeric EphA2 and the protein-protein interaction inhibitor UniPR1331) on the local and systemic inflammatory responses triggered by mesenteric I/R in mice. Read More

    Acute pancreatitis caused by pancreatic ischemia after TEVAR combined with intentional celiac artery coverage and embolization of the branches of the celiac artery.
    J Surg Case Rep 2017 Feb 23;2017(2):rjx029. Epub 2017 Feb 23.
    Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, Matsudo-Shi, Chiba-Ken, Japan.
    Covering and embolizing the celiac artery has been reported to be a relatively safe procedure, owing to the rich collateral pathway between the celiac artery and superior mesenteric artery. A 69-year-old man presented with an aneurysm on the distal descending aorta. The proximity of the aneurysm to the celiac artery origin necessitated covering the artery with a stent graft. Read More

    Hepatic Artery Thrombosis After Liver Transplantation: Five-Year Experience at the State University of Campinas.
    Transplant Proc 2017 May;49(4):867-870
    Unit of Liver Transplantation Unit, State University of Campinas, Campinas, Brazil. Electronic address:
    Background: Hepatic artery thrombosis (HAT) is reported in 4%-15% of orthotopic liver transplants. Risk factors include technical error in the anastomosis, vascular anatomic variation, and high microvascular resistance. The aim of this study was to verify the incidence of HAT, early or late, and possible risk factors. Read More

    Method of Direct Segmental Intra-hepatic Delivery Using a Rat Liver Hilar Clamp Model.
    J Vis Exp 2017 Apr 2(122). Epub 2017 Apr 2.
    Collaboration for Organ Perfusion, Protection, Engineering and Regeneration (COPPER) Lab, Division of Transplant, Department of Surgery, Comprehensive Transplant Center, The Ohio State University Wexner Medical Center;
    Major hepatic surgery with inflow occlusion, and liver transplantation, necessitate a period of warm ischemia, and a period of reperfusion leading to ischemia/reperfusion (I/R) injury with myriad negative consequences. Potential I/R injury in marginal organs destined for liver transplantation contributes to the current donor shortage secondary to a decreased organ utilization rate. A significant need exists to explore hepatic I/R injury in order to mediate its impact on graft function in transplantation. Read More

    A Systematic Review of the Clinical Presentation, Diagnosis, and Treatment of Small Bowel Obstruction.
    Curr Gastroenterol Rep 2017 Jun;19(6):28
    Division of Gastroenterology and Hepatology, Department of Medicine, William Beaumont Hospital, 3535 West Thirteen Mile Road, Royal Oak, MI, 48073, USA.
    Purpose Of Review: This study aimed to systematically review small bowel obstruction (SBO), focusing on recent changes in diagnosis/therapy.

    Recent Findings: SBO incidence is about 350,000/annum in the USA. Etiologies include adhesions (65%), hernias (10%), neoplasms (5%), Crohn's disease (5%), and other (15%). Read More

    Fatal Acute Hemorrhagic Bowel Infarction Caused by Mesenteric Venous Thrombosis.
    J Forensic Sci 2017 Apr 20. Epub 2017 Apr 20.
    Departments of Forensic Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
    Acute mesenteric venous thrombosis (MVT) is a rare, but life-threatening medical phenomenon. MVT is normally characterized by insidious onset, with nonspecific signs and symptoms. A high index of clinical suspicion is required for diagnosis, and emergency surgery is necessary to optimize the chances of patient survival, especially in the people aged more than 70 years. Read More

    Oral magnesium supplementation reduces the incidence of gastrointestinal complications following cardiac surgery: a randomized clinical trial.
    Magnes Res 2017 Feb;30(1):28-34
    Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
    Gastrointestinal complications are common after coronary artery bypass graft surgery. These complications are ranged from nausea and vomiting to mesenteric ischemia and liver failure. It seems that nausea, vomiting, and constipation are related to magnesium deficiency. Read More

    Successful treatment of nonocclusive mesenteric ischemia after aortic valve replacement with continuous arterial alprostadil infusion: A case report.
    Int J Surg Case Rep 2017 30;35:8-11. Epub 2017 Mar 30.
    Department of Surgery, Jichi medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. Electronic address:
    Introduction: Nonocclusive mesenteric ischemia (NOMI) after surgery has an extremely poor prognosis with a mortality rate of 30-100%. We report a patient with NOMI following aortic valve replacement who failed to improve despite continuous intra-arterial infusion of papaverine, but was successfully treated with alprostadil (prostaglandin E1 [PGE1]) infusion.

    Presentation Of Case: The patient is a 77-year-old man who underwent aortic valve replacement. Read More

    Early initiation of argatroban therapy in the management of acute superior mesenteric venous thrombosis.
    Exp Ther Med 2017 Apr 7;13(4):1526-1534. Epub 2017 Feb 7.
    Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China.
    Acute superior mesenteric venous thrombosis (ASMVT) is an intractable disease with poor prognosis. Argatroban, a direct thrombin inhibitor, may be a novel anticoagulant method in the therapy of ASMVT. The aim of the present study was to assess the efficacy and safety of early argatroban therapy in ASMVT patients. Read More

    Dietary salt blunts vasodilation by stimulating epithelial sodium channels in endothelial cells from salt-sensitive Dahl rats.
    Br J Pharmacol 2017 Apr 13. Epub 2017 Apr 13.
    Department of Physiology, Emory University School of Medicine, Atlanta, GA, USA.
    Background And Purpose: Our recent studies show that the reduced activity of epithelial sodium channels (ENaC) in endothelial cells accounts for the adaptation of vasculature to salt in Sprague-Dawley rats. The present study examines a hypothesis that enhanced ENaC activity mediates the loss of vasorelaxation in Dahl salt-sensitive (SS) rats.

    Experimental Approach: We used the cell-attached patch-clamp technique to record ENaC activity in split-open mesenteric arteries. Read More

    Value of Multi-detector CT in Detection of Isolated Spontaneous Superior Mesenteric Artery Dissection.
    Chin Med Sci J 2017 Apr;32(1):28-33
    Department of Radiology, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
    Objective To investigate the role of multi-detector computed tomography (CT) in the diagnosis and classification of isolated spontaneous superior mesenteric artery dissection (ISSMAD). Methods From July 2012 to December 2016, 30 consecutive patients with ISSMAD underwent CT scan at least two times. We retrospectively summarized the clinical characteristics and CT findings of them. Read More

    Liver necrosis shortly after pancreaticoduodenectomy with resection of the replaced left hepatic artery.
    World J Surg Oncol 2017 Apr 11;15(1):77. Epub 2017 Apr 11.
    Shiga Medical Center for Adults, 4-30 Moriyama 5-chome, Moriyama city, Shiga Prefecture, 524-8524, Japan.
    Background: Surgeons, in general, underestimate the replaced left hepatic artery (rLHA) that arises from the left gastric artery (LGA), compared with the replaced right hepatic artery (rRHA), especially in standard gastric cancer surgery. During pancreaticoduodenectomy (PD), preservation of the rRHA arising from the superior mesenteric artery (SMA) is widely accepted to prevent critical postoperative complications, such as liver necrosis, bile duct ischemia, and biliary anastomotic leakage. In contrast, details of complication onset following rLHA resection remain unknown. Read More

    Mesenteric vascular treatment 2016: from open surgical repair to endovascular revascularization.
    Best Pract Res Clin Gastroenterol 2017 Feb 11;31(1):75-84. Epub 2017 Feb 11.
    Department of Vascular Surgery, Medical Spectrum Twente, Enschede, The Netherlands; Experimental Centre for Technical Medicine, University of Twente, Enschede, The Netherlands. Electronic address:
    The rise of endovascular techniques has improved the outcome of mesenteric ischemia. Key principle in reduction of morbidity and mortality is "revascularization first, resection later". We believe that mesenteric ischemia is a clinical challenge demanding 24/7 multidisciplinary team availability. Read More

    Serological markers for human intestinal ischemia: A systematic review.
    Best Pract Res Clin Gastroenterol 2017 Feb 7;31(1):69-74. Epub 2017 Feb 7.
    Vascular Center, Skane University Hospital, Malmö, Sweden. Electronic address:
    Early and accurate diagnosis of intestinal ischemia is important in order to provide rapid and correct treatment and reduce morbidity and mortality rates. Clinical signs and symptoms are often unspecific. This systemic review sums up literature regarding human plasma biomarkers for acute mesenteric ischemia reported during the last ten years. Read More

    Functional testing in the diagnosis of chronic mesenteric ischemia.
    Best Pract Res Clin Gastroenterol 2017 Feb 4;31(1):59-68. Epub 2017 Jan 4.
    Medisch Spectrum Twente, Department of Gastroenterology and Hepatology, Enschede, The Netherlands; Universitair Medisch Centrum Groningen, Department of Gastroenterology and Hepatology, Groningen, The Netherlands. Electronic address:
    Chronic mesenteric ischemia (CMI) results from insufficient oxygen delivery or utilization to meet metabolic demand. Two main mechanisms may lead to mesenteric ischemia: occlusion in the arteries or veins of the gastrointestinal tract, or reduced blood flow from shock states or increased intra-abdominal pressure, so-called non-occlusive mesenteric ischemia. Severe stenoses in the three main mesenteric vessels as demonstrated with CT-angiography or MR-angiography are sufficient to proof mesenteric ischemia, for example in patients who present with weight loss, postprandial pain and diarrhea. Read More

    Diagnosis and treatment of chronic mesenteric ischemia: An update.
    Best Pract Res Clin Gastroenterol 2017 Feb 7;31(1):49-57. Epub 2017 Feb 7.
    Medisch Spectrum Twente, Department of Vascular Surgery, Enschede, The Netherlands; University of Twente, Faculty of Science and Technology, Enschede, The Netherlands. Electronic address:
    Although the prevalence of mesenteric artery stenoses (MAS) is high, symptomatic chronic mesenteric ischemia (CMI) is rare. The collateral network in the mesenteric circulation, a remnant of the extensive embryonal vascular network, serves to prevent most cases of ischemia. This explains the high incidence of MAS and relative rarity of cases of CMI. Read More

    Testing for thrombophilia in mesenteric venous thrombosis - Retrospective original study and systematic review.
    Best Pract Res Clin Gastroenterol 2017 Feb 4;31(1):39-48. Epub 2017 Jan 4.
    Lund University, Department of Vascular Diseases, Skåne University Hospital, S-205 02 Malmö, Sweden. Electronic address:
    The aim was to perform a local study of risk factors and thrombophilia in mesenteric venous thrombosis (MVT), and to review the literature concerning thrombophilia testing in MVT. Patients hospitalized for surgical or medical treatment of MVT at our center 2000-2015. A systematic review of observational studies was performed. Read More

    Vascular imaging of the mesenteric vasculature.
    Best Pract Res Clin Gastroenterol 2017 Feb 5;31(1):3-14. Epub 2017 Jan 5.
    Department of Radiology, Erasmus University Medical Center, 's Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. Electronic address:
    Imaging of the mesenteric vasculature is crucial in diagnosing vascular disease of the gastro-intestinal tract such as acute or chronic mesenteric ischemia caused by arterial stenosis, embolism or thrombosis, mesenteric vein thrombosis and mesenteric aneurysm or dissection. The reference standard for imaging of the mesenteric vasculature is digital subtraction angiography. However, modalities as duplex ultrasonography, computed tomography angiography and magnetic resonance angiography are developing rapidly and may provide accurate imaging non-invasively. Read More

    Acute mesenteric ischemia (Part II) - Vascular and endovascular surgical approaches.
    Best Pract Res Clin Gastroenterol 2017 Feb 4;31(1):27-38. Epub 2017 Jan 4.
    Department of Clinical Sciences Malmö, Lund University, Sweden. Electronic address:
    The modern treatment of acute mesenteric ischemia (AMI) requires seamless collaboration of gastrointestinal surgeons, vascular surgeons, and interventional radiologists. The treatment strategy is straightforward aiming at rapid restoration of blood flow to the intestine. Bowel resection is performed on demand. Read More

    Acute mesenteric ischemia (part I) - Incidence, etiologies, and how to improve early diagnosis.
    Best Pract Res Clin Gastroenterol 2017 Feb 4;31(1):15-25. Epub 2017 Jan 4.
    Department of Clinical Sciences Malmö, Lund University, Sweden. Electronic address:
    Acute mesenteric ischemia (AMI) is generally thought to be a rare disease, but in fact, it is more common cause of acute abdomen than appendicitis or ruptured abdominal aortic aneurysm in patients over 75 years of age. In occlusive AMI, surgical treatment without revascularization is associated with as high as 80% overall mortality. It has been shown that early diagnosis with contrast-enhanced computed tomography and revascularization can reduce the overall mortality in AMI by up to 50%. Read More

    Colon ischemia: Right-sided colon involvement has a different presentation, etiology and worse outcome. A large retrospective cohort study in histology proven patients.
    Best Pract Res Clin Gastroenterol 2017 Feb 13;31(1):111-117. Epub 2017 Jan 13.
    Department of Gastroenterology, Medical Spectrum Twente, Enschede, The Netherlands; Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands. Electronic address:
    Background: Colon ischemia (CI), is generally considered a non-occlusive mesenteric ischemia disorder that usually runs a benign course, but right-sided involvement (RCI) has been associated with worse outcome. The poor outcome of RCI has been associated with comorbidity, but more recently also with occlusions of the mesenteric arteries. We performed a retrospective analysis of a large cohort of CI-patients to assess differences in presentation, etiology, and comorbidity between right-sided colon ischemia (RCI) and non-right-sided colon ischemia (NRCI), and their relation to outcome. Read More

    The use of super-selective mesenteric embolisation as a first-line management of acute lower gastrointestinal bleeding.
    Ann Med Surg (Lond) 2017 May 23;17:27-32. Epub 2017 Mar 23.
    Department of Surgery, Western Health, 160 Furlong Road, Footscray, Melbourne, Victoria 3011, Australia; The University of Melbourne, Melbourne Medical School - Western Precinct, Western Health, Sunshine Hospital 176, Furlong Road, St Albans, Melbourne, Victoria 3021, Australia.
    Introduction: In this study, we aim to assess the efficacy and safety of digital subtraction angiography (DSA) and super-selective mesenteric artery embolisation in managing lower gastrointestinal bleeding (LGIB) at a multi-centre health service in Melbourne (Australia).

    Method: A retrospective case series of patients with LGIB treated with superselective embolisation in our area health service. Patients with confirmed active LGIB, on either radionuclide scintigraphy (RS) or contrast-enhanced multi-detector CT angiography (CE-MDCT), were referred for DSA, and subsequently endovascular intervention. Read More

    17β-Estradiol prevents mesenteric injury induced by occlusion of the proximal descending aorta in male rats.
    J Vasc Surg 2017 Apr 3. Epub 2017 Apr 3.
    Heart Institute (InCor), LIM 11, University of São Paulo Medical School, São Paulo, São Paulo, Brazil. Electronic address:
    Objective: In surgical aortic repair or cardiac surgery with aorta occlusion, the occurrence of mesenteric ischemia and bowel injury has been associated with higher short-term mortality. The vascular protection of estrogens has been investigated and is mainly mediated by increasing the availability of nitric oxide (NO). Therefore, this study investigated the role of 17β-estradiol on visceral ischemia-reperfusion (I/R) injury after descending aorta occlusion in male rats. Read More

    Symptomatic Delayed Aortic Dissection After Superior Mesenteric Artery Stenting for Chronic Mesenteric Ischemia.
    Vasc Endovascular Surg 2017 Jan 1:1538574417702775. Epub 2017 Jan 1.
    3 OhioHealth Comprehensive Heart and Vascular Center, OhioHealth Mansfield Hospital, Mansfield, OH, USA.
    Chronic mesenteric ischemia most commonly occurs secondary to atherosclerotic disease of the mesenteric arteries. Patients are often older than 60 years and can present with postprandial abdominal pain, nausea, diarrhea, and significant weight loss. Symptomatic disease has traditionally been managed with open surgical repair, but endovascular strategies, such as percutaneous angioplasty and stenting, have emerged as the mainstays of therapy. Read More

    A cause of porto-mesenteric pneumatosis not secondary to intestinal ischemia.
    Rev Esp Enferm Dig 2017 Apr;109(4):285-286
    Cirugia General, Fundación Althaia. Xarxa assistencial.
    The finding of portal pneumatosis may be related to multiple etiologies such as intestinal inflammatory diseases, intestinal infectious diseases, chemotherapy and radiotherapy treatments or advanced stages of intestinal ischemia. The gold standard for diagnosis is computed tomography, and once the findings are observed, proper differential diagnosis must be asserted to prevent unnecessary laparotomies. Read More

    Iloprost, prostaglandin E1, and papaverine relax human mesenteric arteries with similar potency.
    Shock 2017 Mar 30. Epub 2017 Mar 30.
    *Institute of Diagnostic Radiology and Neuroradiology, University of Greifswald †Department of General Surgery, University of Greifswald ‡Department of Physiology, University of Greifswald.
    Objective: Non-occlusive mesenteric ischemia (NOMI) is accompanied by mesenteric artery spasms that are at least in part due to endothelin system activation. Acute treatment includes intra-arterial infusion of vasodilators such as iloprost, prostaglandin E1 (PGE1) and papaverine. Their effectiveness is not well characterized in human mesenteric arteries. Read More

    Trends in Treatment and Mortality for Mesenteric Ischemia in the United States from 2000 to 2012.
    Ann Vasc Surg 2017 Mar 28. Epub 2017 Mar 28.
    Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA. Electronic address:
    Background: It is unknown whether increased endovascular treatment of chronic mesenteric ischemia has led to decreases in open surgery, acute mesenteric ischemia, or overall mortality. The present study evaluates the trends in endovascular and open treatment over time for chronic and acute mesenteric ischemia.

    Methods: We identified patients with chronic or acute mesenteric ischemia in the Nationwide Inpatient Sample and Center for Disease Control and Prevention database from 2000 to 2012. Read More

    Estradiol Modulates Local Gut Injury Induced by Intestinal Ischemia-Reperfusion in Male Rats.
    Shock 2017 Mar 29. Epub 2017 Mar 29.
    *Laboratory of Cardiovascular Surgery and Circulation Pathophysiology (LIM-11), Heart Institute (InCor), Medical School †Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
    Intestinal ischemia and reperfusion (I/R) triggers a systemic inflammatory response characterized by leukocyte mobilization from the bone marrow, release of cytokines to the circulation, and increased microvascular permeability, leading to high mortality. Females have shown attenuated inflammatory response to trauma when compared to males, indicating a role for female sex hormones in this process. Here we have evaluated the effect of estradiol on the local gut injury induced by I/R in male rats. Read More

    Protectin D1n-3 DPA and resolvin D5n-3 DPA are effectors of intestinal protection.
    Proc Natl Acad Sci U S A 2017 Apr 29;114(15):3963-3968. Epub 2017 Mar 29.
    The William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London, London EC1M 6BQ, United Kingdom;
    The resolution of inflammation is an active process orchestrated by specialized proresolving lipid mediators (SPM) that limit the host response within the affected tissue; failure of effective resolution may lead to tissue injury. Because persistence of inflammatory signals is a main feature of chronic inflammatory conditions, including inflammatory bowel diseases (IBDs), herein we investigate expression and functions of SPM in intestinal inflammation. Targeted liquid chromatography-tandem mass spectrometry-based metabololipidomics was used to identify SPMs from n-3 polyunsaturated fatty acids in human IBD colon biopsies, quantifying a significant up-regulation of the resolvin and protectin pathway compared with normal gut tissue. Read More

    Mesenteric inflammatory veno-occlusive disease of the spleen metasynchronous with two arterial thrombotic events in systemic lupus erythematosus.
    Lupus 2017 Jan 1:961203317700980. Epub 2017 Jan 1.
    1 Immunology and Allergy, Department of Internal Medicine Specialties, University Hospital and School of Medicine, Geneva, Switzerland.
    Vasculitides, particularly those affecting small vessels, are known to complicate systemic lupus erythematosus (SLE); however, isolated venulitis of the mesenteric bed has rarely been reported. Here we relate the case of a 46-year-old woman with SLE who presented with acute abdominal pain due to artery thrombosis and extended splenic ischemia requiring splenectomy. The histological examination revealed diffuse venulitis in the absence of arterial vasculitis consistent with the definition of mesenteric inflammatory veno-occlusive disease (MIVOD). Read More

    Microscopic polyangiitis: Atypical presentation with extensive small bowel necrosis, diffuse alveolar hemorrhage, and renal failure.
    Respir Med Case Rep 2017 4;21:12-15. Epub 2017 Mar 4.
    Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States.
    Microscopic polyangiitis is an uncommon systemic vasculitis of varying severity that is associated with myeloperoxidase (MPO) and perinuclear antineutrophil cytoplasmic (p-ANCA) antibodies. The most commonly affected organs are the lungs and kidneys. We report on a very unusual case of microscopic polyangiitis presenting with severe mesenteric ischemia in addition to diffuse alveolar hemorrhage and acute renal failure. Read More

    Open and Endovascular Abdominal Aortic Injury Repair Outcomes in Polytrauma Patients.
    Ann Vasc Surg 2017 Mar 21. Epub 2017 Mar 21.
    Department of Surgery, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY.
    Introduction: The management of patients with abdominal aortic injury (AAI) remains challenging. Open repair of AAI is still the standard of care although it is associated with high mortality. In past few years, endovascular surgery has evolved as a less invasive alternative to open surgery in emergency settings. Read More

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