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Semin Thromb Hemost 2021 Jun 11. Epub 2021 Jun 11.

Department of Medicine and Surgery, University of Insubria, Varese, Italy.

Splanchnic vein thrombosis (SVT), which includes portal, mesenteric, and splenic vein thrombosis and the Budd-Chiari syndrome, is an infrequent manifestation of venous thromboembolism (VTE). Like typical site VTE, SVT is also frequently associated with cancer, particularly intra-abdominal solid malignancies and myeloproliferative neoplasms (MPNs). The clinical presentation of SVT is nonspecific. Read More

J Crit Care 2021 Jun 4;65:72-75. Epub 2021 Jun 4.

SC Anestesia e Rianimazione II, Ospedale San Carlo Borromeo, ASST Santi Paolo e Carlo - Polo Universitario, Milano, Italy.

Several cases of deep venous thrombosis in people who had recently received Vaxzevria (previously known as COVID-19 Vaccine AstraZeneca) have recently been reported, mainly presenting as cerebral vein/cerebral venous sinus thrombosis. This syndrome has been termed "vaccine-induced immune thrombotic thrombocytopenia (VITT)". Acute spleno-porto-mesenteric vein thrombosis is an uncommon but serious condition with potential sequelae, such as small-bowel gangrene and end-stage liver failure. Read More

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

J Anaesthesiol Clin Pharmacol 2021 Jan-Mar;37(1):132-133. Epub 2021 Apr 10.

Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India.

CVIR Endovasc 2021 Jun 7;4(1):47. Epub 2021 Jun 7.

Department of Radiology - Papa Giovanni XXIII Hospital, University of Milano Bicocca, Piazza OMS 1, 24127, Bergamo, Italy.

Background: Anomalies of the portal venous system can be congenital or acquired, the latter being related to spontaneous thrombosis or iatrogenic alterations such as complications of perinatal catheterization of the umbilical vein. These conditions can be clinically silent for years and then manifest abruptly causing severe clinical emergencies.

Case Presentation: This case report describes the diagnosis and interventional management of a singular abnormality in the portal venous system of an 8-year-old female that led to severe portal hypertension and acute variceal bleeding. Read More

Cureus 2021 May 2;13(5):e14799. Epub 2021 May 2.

Pediatric Emergency Medicine, Broward Health Medical Center, Fort Lauderdale, USA.

An acute abdomen is a complex case with multiple possible etiologies and requires the help of many different disciplines. We present the case of a two-year-old female who presented to the emergency department in acute distress, pale in complexion, and continuously guarding her abdomen. Physical examination revealed a distended, rigid abdomen with tenderness to palpation of the abdomen in all four quadrants. Read More

J Vasc Bras 2021 Mar 15;20:e20200105. Epub 2021 Mar 15.

Universidade Federal do Ceará - UFC, Faculdade de Medicina, Sobral, Sobral, CE, Brasil.

The purpose of this article is to report the case of a 53-year-old black man, with no previous comorbidities, who presented 48 days after a confirmed diagnosis of COVID-19, complaining of an initially insidious epigastric pain that had progressed to severe pain radiating to the interscapular vertebral region, with hyporexia and episodes of projectile vomiting, with no nausea or fever. Laboratory tests revealed no signs of acute infection or pancreatic injury. Abdominal computed tomography showed dilated, fluid-filled small bowel loops with thickened walls. 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

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

J Trauma Acute Care Surg 2021 Jun 4. Epub 2021 Jun 4.

HUS Abdominal Center, Abdominal Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland HUS Abdominal Center, Vascular Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland HUS Medical Imaging Center, Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland HUS Abdominal Center, Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Background: Acute mesenteric ischemia (AMI) is a disease with high mortality and requires a multidisciplinary approach for effective management. A pathway and care bundle were developed and implemented with the objective to reduce mortality. The aim of this retrospective comparative study was to analyze the effects of the pathway on patient management and outcome. Read More

Int J Surg Case Rep 2021 May 26;83:106022. Epub 2021 May 26.

Royal Commission Jubail and Yanbu, Saudi Arabia.

Introduction And Importance: Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a poorly understood disorder which poses a diagnostic challenge to clinicians and pathologists. Here we have described the case of a male patient with IMHMV along with a presumed history of ulcerative colitis for 1 year.

Case Presentation: A 55-year-old male presented to the OPD with history of chronic abdominal pain. Read More

Anesth Analg 2021 Jun 1. Epub 2021 Jun 1.

Department of Anesthesiology, Stony Brook Medicine, Stony Brook, New York.

While intraoperative mortality has diminished greatly over the last several decades, the risk of death within 30 days of surgery remains stubbornly high and is ultimately related to perioperative organ failure. Perioperative strokes, while rare (<2% in noncardiac surgery), are associated with a more than 10-fold increase in mortality. Rapid identification and treatment are key to maximizing long-term outcomes. Read More

Antioxid Redox Signal 2021 Jun 2. Epub 2021 Jun 2.

University of Tsukuba, Tsukuba, Japan;

Significance: Ischemia-reperfusion injury is a major component of severe damage in vascular occlusion during stroke, myocardial infarction, surgery, and organ transplantation, and is exacerbated by the excessive generation of reactive oxygen species, which occurs particularly during reperfusion. With the aging of the population, ischemia-reperfusion injury is becoming a serious problem in various organs, such as the kidney, brain, and heart, as well as in the mesenteric capillaries. Recent Advances: To prevent reperfusion injuries, natural and synthetic low-molecular-weight antioxidants have been well studied. Read More

Pharmaceuticals (Basel) 2021 May 24;14(6). Epub 2021 May 24.

Department of Food and Drug, University of Parma, Parco Area delle Scienze 27/a, 43124 Parma, Italy.

Eph receptors, comprising A and B classes, interact with cell-bound ephrins generating bidirectional signaling. Although mainly related to carcinogenesis and organogenesis, the role of Eph/ephrin system in inflammation is growingly acknowledged. Recently, we showed that EphA/ephrin-A proteins can modulate the acute inflammatory responses induced by mesenteric ischemia/reperfusion, while beneficial effects were granted by EphB4, acting as EphB/ephrin-B antagonist, in a murine model of Crohn's disease (CD). 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

Diagnostics (Basel) 2021 May 30;11(6). Epub 2021 May 30.

Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, Antonio Cardarelli St. 9, 80131 Naples, Italy.

Ischemic colitis represents the most frequent form of intestinal ischemia occurring when there is an acute impairment or chronic reduction in the colonic blood supply, resulting in mucosal ulceration, inflammation, hemorrhage and ischemic necrosis of variable severity. The clinical presentation is variable and nonspecific, so it is often misdiagnosed. The most common etiology is hypoperfusion, almost always associated with generalized atherosclerotic disease. 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

Biomed Res Int 2021 17;2021:6672591. Epub 2021 May 17.

University of Manitoba, Manitoba, Canada.

The study is aimed at assessing whether the early surgical intervention improves survival in acute mesenteric ischemia with septic shock. A retrospective study design was applied to review the charts of patients admitted to the intensive care unit. The data were collected through a review of the full patient chart including physician and nursing notes, pathology reports, intraoperative findings, CT findings, and endoscopy. 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

AJR Am J Roentgenol 2021 May 26:1-8. Epub 2021 May 26.

Department of Radiology, Okan University Hospital, Aydinli Yolu Cad No 2, Tuzla, Istanbul, Turkey, 34940.

The purpose of this study was to evaluate the safety and efficacy of transhepatic pharmacomechanical thrombectomy of symptomatic acute portomesenteric venous thrombosis. Transhepatic pharmacomechanical thrombectomy (catheter-directed thrombolysis with mechanical thrombectomy) was performed in the treatment of nine patients with symptomatic acute noncirrhotic, nonmalignant porto-mesenteric venous thrombosis. The medical records, imaging examinations, technique of transhepatic pharmacomechanical thrombectomy, and clinical outcomes were reviewed. 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

Int J Surg Case Rep 2021 May 12;83:105974. Epub 2021 May 12.

Critical Care Unit, Ahamdi Hospital, Kuwait Oil Company, Kuwait. Electronic address:

Introduction: Portal venous gas is a rare finding in adults and is typically associated with underlying intestinal ischemia. Portal venous gas can be detected by a bedside point of care ultrasound (POCUS) examination in adult patients in critical care units (CCU). Findings include echogenic bubbles flowing centrifugally throughout the portal venous system. Read More

Hepatology 2021 May 21. Epub 2021 May 21.

Department of Radiology, Section of Vascular and Interventional Radiology, Northwestern University, Chicago, USA.

Extrahepatic portal vein occlusion (EHPVO) from portal vein thrombosis is a rare condition associated with substantial morbidity and mortality. The purpose of this study is to investigate the efficacy of TIPS for the treatment of chronic EHPVO, cavernomatosis and mesenteric venous thrombosis in non-cirrhotic adults refractory to standard of care therapy. 39 patients with chronic EHPVO received TIPS. Read More

Front Med (Lausanne) 2021 4;8:644195. Epub 2021 May 4.

Department of Emergency Medicine, Osaka Medical College Hospital, Takatsuki, Japan.

Vasopressin is one of the strong vasopressor agents associated with ischemic events. Responses to the administration of vasopressin differ among patients with septic shock. Although the administration of a high dose of vasopressin needs to be avoided, the effects of bolus loading have not yet been examined. Read More

Pancreas 2021 May-Jun 01;50(5):751-755

From the Departments of Surgery.

Objectives: This study aimed to quantify the prevalence of venous thromboembolic (VTE) events in patients with pancreatitis requiring hospitalization and its impact on outcomes.

Methods: Adult patients admitted from 2011 to 2018 for pancreatitis were identified. Every admission for pancreatitis in the first year after diagnosis was evaluated for a VTE (pulmonary embolism, deep vein thrombosis, or mesenteric vessel thrombosis) within 30 days of discharge. Read More

Niger J Surg 2021 Jan-Jun;27(1):16-21. Epub 2021 Mar 9.

Department of General Surgery, V.M.M.C and Safdarjung Hospital, New Delhi, India.

Introduction: Acute mesenteric ischemia (AMI) is the sudden onset of small intestinal hypoperfusion, which can be due to reduction or cessation of arterial inflow. It can be embolic or thrombotic. AMI is a potentially fatal vascular emergency, with overall mortality of 60%-80%. Read More

J Med Case Rep 2021 May 19;15(1):280. Epub 2021 May 19.

University of Puerto Rico Medical Sciences Campus, Paseo Dr. José Celso Barbosa, San Juan, PR, 00921, USA.

Background: Acute portal vein thrombosis is a rare medical event usually seen in liver disease, but it can also occur due to any inherited or acquired procoagulable state that triggers venous occlusion. Hormonal therapies have been associated with an increased risk of prothrombotic states. This case report documents a portomesenteric venous thrombosis in a postmenopausal woman with testosterone implant for the treatment of hypoactive sexual desire and discusses the importance of identifying hypercoagulable risk factors before initiating hormone replacement therapy. Read More

BMC Surg 2021 May 19;21(1):247. Epub 2021 May 19.

Department of Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Hiroshima, Japan.

Background: The incidence of postoperative venous thromboembolism (VTE) is high in patients with inflammatory bowel disease. We aimed to analyze the incidence and predictive factors of postoperative VTE in patients with ulcerative colitis.

Methods: Patients with ulcerative colitis who underwent colon and rectum surgery during 2010-2018 were included. Read More