2.A Case of Budd-Chiari Syndrome and Superior Mesenteric Vein Thrombosis in Ulcerative Colitis.
So Young PARK ; Yoon Jae KIM ; In Hae PARK ; Chang Mo MOON ; Chang Whan CHOI ; Sang Kil LEE ; Haeryoung KIM ; Young Nyun PARK ; Tae Il KIM ; Won Ho KIM
The Korean Journal of Gastroenterology 2005;45(3):201-205
Patients with inflammatory bowel disease are at increased risk for thromboembolic complications. Its prevalence rate ranges from 1% to 7% in clinical studies and reaches 39% in autopsy series. The cause of thrombotic complications in inflammatory bowel disease is generally considered to be associated with hypercoagulability. We experienced a case of ulcerative colitis associated with Budd-Chiari syndrome and superior mesenteric vein thrombosis. This rare complication of ulcerative colitis was successfully managed by conventional treatment for ulcerative colitis and anticoagulation therapy.
Adult
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Colitis, Ulcerative/*complications
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English Abstract
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Female
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Hepatic Vein Thrombosis/*complications
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Humans
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Mesenteric Vascular Occlusion/*complications
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Mesenteric Veins
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Venous Thrombosis/*complications
4.Isolated Spontaneous Dissection of Superior Mesenteric Artery: Treated by Percutaneous Endovascular Stent Placement.
Jae Wuk KWAK ; Chang Nyol PAIK ; Kang Moon LEE ; Woo Chul CHUNG ; Sung Hoon JUNG ; Ji Eun KIM ; Jun Hyun BAIK ; Jin Mo YANG
The Korean Journal of Gastroenterology 2010;55(1):58-61
Isolated spontaneous dissection of the superior mesenteric artery (SMA) without aortic dissection is a rare cause of acute mesenteric ischemia. A sudden decrease of intestinal blood flow can lead to fatal complications such as ischemic necrosis, shock, and death. Therefore, early diagnosis and therapeutic approach before the occurrence of intestinal infarction are the most important factor to determine the patient's prognosis. A 52-year-old male presented with postprandial periumbilical pain, and isolated spontaneous dissection of the superior mesenteric artery with mural thrombus was detected by abdominal computed tomography with contrast enhancement. By the percutaneous implantation of vascular metallic stent via femoral artery, he was treated successfully. We report a case of isolated spontaneous dissection of the SMA treated by a percutaneous endovascular stent replacement with a review of literature.
Aneurysm, Dissecting/complications/*diagnosis/surgery
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Humans
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Male
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*Mesenteric Artery, Superior/radiography
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Mesenteric Vascular Occlusion/etiology/surgery
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Middle Aged
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*Stents
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Tomography, X-Ray Computed
5.Isolated Spontaneous Dissection of Superior Mesenteric Artery: Treated by Percutaneous Endovascular Stent Placement.
Jae Wuk KWAK ; Chang Nyol PAIK ; Kang Moon LEE ; Woo Chul CHUNG ; Sung Hoon JUNG ; Ji Eun KIM ; Jun Hyun BAIK ; Jin Mo YANG
The Korean Journal of Gastroenterology 2010;55(1):58-61
Isolated spontaneous dissection of the superior mesenteric artery (SMA) without aortic dissection is a rare cause of acute mesenteric ischemia. A sudden decrease of intestinal blood flow can lead to fatal complications such as ischemic necrosis, shock, and death. Therefore, early diagnosis and therapeutic approach before the occurrence of intestinal infarction are the most important factor to determine the patient's prognosis. A 52-year-old male presented with postprandial periumbilical pain, and isolated spontaneous dissection of the superior mesenteric artery with mural thrombus was detected by abdominal computed tomography with contrast enhancement. By the percutaneous implantation of vascular metallic stent via femoral artery, he was treated successfully. We report a case of isolated spontaneous dissection of the SMA treated by a percutaneous endovascular stent replacement with a review of literature.
Aneurysm, Dissecting/complications/*diagnosis/surgery
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Humans
;
Male
;
*Mesenteric Artery, Superior/radiography
;
Mesenteric Vascular Occlusion/etiology/surgery
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Middle Aged
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*Stents
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Tomography, X-Ray Computed
6.A Case of Spontaneous Dissection of the Superior Mesenteric Artery Treated by Percutaneous Stent Placement.
Geun Jun KO ; Ki Jun HAN ; Seo Goo HAN ; Sang Yon HWANG ; Chang Hwan CHOI ; Chang Woo GHAM ; Hyeon Geun CHO ; Soon Young SONG ; Jin Ho JUNG
The Korean Journal of Gastroenterology 2006;47(2):168-172
Acute mesenteric ischemia can result from emboli, arterial and venous thrombi or vasoconstriction secondary to low-flow states. Isolated spontaneous dissection of the superior mesenteric artery is a rare cause of acute mesenteric ischemia. The mortality rates of acute mesenteric ischemia averages 71% with a range of 59-93%. Diagnosis before the occurrence of intestinal infarction is the most important factor in improving survival rate for patients with acute mesenteric ischemia. A 68-year-old female presented with postprandial epigastric pain, and a dissection of the superior mesenteric artery and a gallbladder polyp were shown in abdominal computed tomographic scan. After the percutaneous metalic stent placement and laparoscopic cholecystectomy, her symptoms improved. We report a case of spontaneous dissection of main trunk of the superior mesenteric artery which was successfully treated by percutaneous stent placement with a review of literature.
Acute Disease
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Aged
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Aneurysm, Dissecting/complications/*therapy
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*Angioplasty, Balloon
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Female
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Humans
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Ischemia/etiology
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*Mesenteric Artery, Superior
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Mesenteric Vascular Occlusion/etiology
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*Stents
7.Clinicopathologic study of ischemic intestinal disease due to mesenteric venous lesions.
Li-feng WANG ; Ming LIU ; Shu-jie ZHANG ; Wei HAN ; Feng GAO ; Ji-ping QI
Chinese Journal of Pathology 2006;35(10):620-622
OBJECTIVETo study the clinical and pathologic features of ischemic intestinal disease due to mesenteric phlebitis.
METHODThe clinical and pathologic features of the mesenteric venous lesions in 3 patients of ischemic intestinal disease admitted during the period from 2003 to 2004 were studied.
RESULTSAll 3 patients had a clinical history of acute abdominal pain accompanying with a diffuse peritonitis. During operation, an infarcted intestinal segment was identified and was resected respectively in each patient. Histologic examination showed a lymphocytic infiltration and fibrinoid necrosis of the small to medium-sized veins, associated with mural thrombosis and infarction of the corresponding intestinal wall and mesentery. The mesenteric arteries were spared. Two-year follow up of one case showed no evidence of local recurrence or systemic vasculitis.
CONCLUSIONSIschemic intestinal disease due to mesenteric phlebitis is a rare entity with a pathological feature of inflammation of venous wall accompanying with the development of mural thrombosis and subsequent haemorrhagic infarction of intestine. The etiology is unknown and surgical resection of the involved intestinal segment is usually recommended.
Adult ; Aged ; Colitis, Ischemic ; etiology ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Intestinal Diseases ; etiology ; pathology ; surgery ; Intestine, Small ; blood supply ; pathology ; surgery ; Ischemia ; complications ; Male ; Mesenteric Vascular Occlusion ; complications ; Mesenteric Veins ; pathology ; Middle Aged ; Phlebitis ; complications
8.Therapeutic effect of zinc sulfate on lung injury during superior mesenteric artery occlusion(SMAO) shock.
You-Ling JING ; Chun-Xiu ZHAO ; Guo-Xian DUAN ; Yan-Lei WANG ; Yong-Qi HU ; Lian-Yuan ZHANG
Chinese Journal of Applied Physiology 2006;22(1):90-93
AIMTo study preventive and therapeutic effect of zinc sulfate on lung injury during superior mesenteric artery occlusion (SMAO) shock and their mechanism of action.
METHODSModel of rabbit SMAO shock was made. The effect of zinc sulfate on the malondialdehyde (MDA) in erythrocyte membrane and plasma, oxidase (XOD) in plasma, superoxide dismutase (SOD) in erythrocyte and MDA, SOD and pulmonary surfactant (PS) in lung tissues homogenate were observed.
RESULTSThe administration of zinc sulfate decreased MDA and XOD, prevented the reduction of SOD and PS, and alleviated lung injury.
CONCLUSIONIt is suggested that lung is injured during SMAO shock and zinc sulfate possesses preventive and therapeutic effect, through stabilized membrane.
Animals ; Female ; Lung ; metabolism ; Lung Injury ; drug therapy ; etiology ; metabolism ; Male ; Mesenteric Artery, Superior ; pathology ; Mesenteric Vascular Occlusion ; complications ; drug therapy ; metabolism ; Rabbits ; Shock ; complications ; drug therapy ; metabolism ; Zinc Sulfate ; therapeutic use
9.Diagnosis and treatment of mesenteric venous thrombosis early after operation.
Kai PAN ; Li-gang XIA ; Xiao-chun CHEN ; Ke-li ZHONG ; Hou-xiang JIANG
Chinese Journal of Gastrointestinal Surgery 2005;8(1):50-52
OBJECTIVETo analyze the clinical characteristics diagnosis and treatment of patients with mesenteric venous thrombosis early after operation.
METHODSA retrospective study was performed on the clinical data of 7 patients with mesenteric venous thrombosis early after operation from 1990 to 2004.
RESULTSPatients had main clinical manifestations of severe abdominal pain and vomiting, but abdominal signs were slight. The systemic toxic symptoms occurred in 2 cases at late course. The examination of abdominal X- ray showed intestinal obstruction of all patients. Four patients received abdominal CT- scanning, of whom 3 patients were diagnosed as mesenteric venous thrombosis. Seven patients received exploratory operation. The necrotic intestinal segments were resected. Two patients had short intestinal syndromes after operation, one of them died of serious malnutrition. Four patients who had recurrence of portal, mesenteric and iliac venous thrombosis needed a long-term therapy of warfarin and aspirin after discharge.
CONCLUSIONIt is easy to make a mistake in diagnosis because of the lacking of characteristic clinical manifestations. Exploratory operation immediately plus anticoagulant therapy is strongly recommended.
Adult ; Female ; Humans ; Male ; Mesenteric Vascular Occlusion ; diagnosis ; drug therapy ; etiology ; Middle Aged ; Postoperative Complications ; diagnosis ; drug therapy ; Retrospective Studies ; Thrombolytic Therapy ; Venous Thrombosis ; diagnosis ; drug therapy ; etiology
10.Damage control surgery for acute mesenteric ischemia.
Jian-Feng GONG ; Wei-Ming ZHU ; Xing-Jiang WU ; Ning LI ; Jie-Shou LI
Chinese Journal of Gastrointestinal Surgery 2010;13(1):22-25
OBJECTIVETo examine the outcome of damage control surgery (DCS) in patients with acute mesenteric ischemia (AMI).
METHODSClinical data of 15 consecutive AMI cases treated with DCS from May 2001 to March 2009 at the Research Institute of General Surgery, Jinling Hospital were retrospectively analyzed. Eleven patients had acute superior mesenteric vein thrombosis (MVT) on admission, and 4 suffered from acute mesenteric arterial embolism/thrombosis (MAE/MAT). The staged damage control approach included immediate resection of the involved bowel (but no attempts to restore gastrointestinal continuity), open thrombectomy, transfer of the patients to ICU for resuscitation, and thrombolysis prior to the planned definitive reconstructive procedure.
RESULTSOf 15 patients, 10 (66.7%) survived. The mean remnant small bowel length was (209.0+/-53.8) cm (120 to 280 cm). None of the survived patients was parenteral nutrition-dependent. Of the 5 deaths, 2 died of recurrence of thrombosis and necrosis of the remaining bowel,1 of massive gastrointestinal bleeding. One patient abandoned treatment intra-operatively, and another with total small bowel resection abandoned treatment postoperatively.
CONCLUSIONSDamage control approach improves the survival of patients with AMI. Thrombectomy and thrombolysis are necessary for AMI management to prevent progression or further development of the thrombosis.
Acute Disease ; Adult ; Female ; Humans ; Intraoperative Complications ; Ischemia ; surgery ; therapy ; Male ; Mesenteric Vascular Occlusion ; surgery ; therapy ; Mesentery ; surgery ; Middle Aged ; Retrospective Studies ; Thrombectomy ; Thrombolytic Therapy