medigraphic.com
ISSN 1025-0255 (Electronic)

2021, Number 1

<< Back Next >>

AMC 2021; 25 (1)

Differential factors between the acute mesenteric ischemia evolutive stages

Fernández-Sanz PL, Sanz-Pupo NJ, Rodríguez-Pascual Y, González-Pérez B

Language: Spanish
References: 25
Page: 46-56
PDF size: 801.21 Kb.


ABSTRACT

Background: the acute mesenteric ischemia is a highly lethal disease, mainly due to the rapid evolution from its premature stage to the late one, the symptomatology in its start-up period and for the complexity of its management.
Objective: to determine the clinical, laboratory, imagenological and evolutionary differences between the stages of the disease.
Methods: an analytical transversal study was carried out. The universe was composed by 32 patients with acute mesenteric ischemia positive diagnosis in the period from December 2015 to March 2018, in Vladimir Ilich Lenin General Hospital.
Results: peritoneal reaction is linked to the advanced stage in a highly significant way. There were no air-fluid levels in most of the ischemic patients, unlike the nechrosis stage, where levels were present in most of the patients. The difference between the pH and lactate average values in both of disease phases were statistically highly significant. All the cases with atrial fibrillation were dianosed in the late stage. All the patients with intestinal necrosis and more than 2/3 of the affected with intestinal ischemia perished.
Conclusions: the delay in diagnosis was associated with high mortality. The early clinical suspicion of an acute abdomen, the assessment of hemodynamic parameters and the identification of risk factors such as atrial fibrillation, favor timely treatment in the ischemic stage and the possibility of survival.


REFERENCES

  1. Liao G, Chen S, Cao H, Wang W, Gao Q. Review: Acute superior mesenteric artery embolism. A vascular emergency cannot be ignored by physicians. Medicine [Internet]. 2019 [citado 07 Dic 2020];98(6):e14446. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380707/.

  2. Memet O, Zhang L, Shen J. Serological biomarkers for acute mesenteric ischemia. Ann Transl Med [Internet]. 2019 [citado 07 Dic 2020];7(16):[aprox. 9 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736808/pdf/atm-07-16-394.pdf

  3. Acosta S, Ogren M, Sternby NH. Incidence of acute thrombo-embolic occlusionof the superior mes-enteric artery-a population-based study. Eur J Vasc Endovasc Surg. 2004;27(2):145-50.

  4. Luzón Solanas L, Montoro Huguet M. Enfermedades del mesenterio, Procesos inflamatorios, Patolo-gía vascular. Isquemia mesentérica. Medicine. 2016;12(4):178-88.

  5. Martínez L, Guadagno H, Saez M. Epidemiología de las emergencias médico quirúrgicas no traumá-ticas. Cuad Chile de Cir. 1986;30:25-30.

  6. Ministerio de Salud Pública. Mortalidad materna según causa. 2017-2019. Anuario estadístico de Salud Pública 2019 [Internet]. La Habana: Dirección de Registros médicos y estadísticas en salud; 2020 [citado 07 Dic 2020]. Disponible en: https://files.sld.cu/bvscuba/files/2020/05/Anuario-Electr%c3%b3nico-Espa%c3%b1ol-2019-ed-2020.pdf

  7. Yildirim D, Hut A, Tatar C, Turgut D, Akinci M, Toptas M. Prognostic factors in patients with acute mesenteric ischemia. Turk J Surg [Internet]. 2017 [citado 07 Dic 2020];33(2):104-109. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508232/pdf/tjs-33-2-104.pdf

  8. Cakir M, Yildirim D, Sarac F, Donmez T, Mirapoglu S, Hut A, et al. In the Experimental Model of Acute Mesenteric Ischemia, The Correlation of Blood Diagnostic Parameters with the Duration of Is-chemia and their Effects on Choice of Treatment. J Inv Surg [Internet]. 2018 [citado 07 Dic 2020];32:1-9. Disponible en: https://www.tandfonline.com/doi/abs/10.1080/08941939.2018.1437486?journalCode=iivs20

  9. Yang H, Wang BL. Evaluation of the diagnostic value of multi-slice spiral CT in acute mesenteric ischemic diseases: a meta-analysis of randomized controlled trials. Eur Rev Med Pharmacol Sci [Internet]. 2019 [citado 07 Dic 2020];23:10218-10225. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31841175/.

  10. Soler Vaillant R, Mederos Curbelo ON, Galiano Gil JM. Isquemias vasculares del intestino. En: So-ler Vaillant R, Mederos Curbelo ON, editores. Cirugía. Afecciones quirúrgicas frecuentes. T. II. La Ha-bana: Editorial Ciencias Médicas; 2016.p. 366-375.

  11. Luther B, Mamopoulos A, Lehmann C, Klar E. The ongoing challenge of acute mesenteric ische-mia. Visc Med [Internet]. 2018 [citado 07 Dic 2020];34:217-223. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103345/.

  12. Marconato R, Nezi G, Capovilla G, Moletta L, Baldan N, Canton SA, et al. Primary mesenteric vein thrombosis: a case series. J Surg Case Rep [Internet]. 2020 [citado 07 Dic 2020];2020(3):16. Dis-ponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092682/.

  13. Florim S, Almeida A, Rocha D, Portugal P. Acute mesenteric ischaemia: a pictorial review. Insigh Imag [Internet]. 2018 [citado 07 Dic 2020];9:673-682. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206376/.

  14. Agrawal SN, Singh K, Dhruv K, Kanwar K. Superior Mesenteric Artery Occlusion: A case report and Mini Review. Int J Med Rev Case Rep [Internet]. 2019 [citado 07 Dic 2020];3(7):478-481. Dis-ponible en: http://mdpub.net/fulltext/172-1555672852.pdf?1609869352

  15. Bala M, Kashuk J, Moore EE, Kluger Y, Biffl W, Gomes CA, et al. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2017;12:38.

  16. Zogheib E, Cosse C, Sabbagh C, Marx S, Caus T, Henry M, et al. Biological scoring system for ear-ly prediction of acute bowel ischemia after cardiac surgery: the PALM score. Ann Intensive Care [Internet]. 2018 [citado 07 Dic 2020];8(1):46. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5906418/.

  17. Destek S, Yabacı A, Abik YN, Gel VO, Değer KC. Predictive and prognostic value of L-lactate, D-dimer, leukocyte, C-reactive protein and neutrophil/lymphocyte ratio in patients with acute mesenter-ic ischemia. Ulus Travma Acil Cerrahi Derg [Internet]. 2020 [citado 07 Dic 2020];26(1):86-94. Dis-ponible en: https://tjtes.org/jvi.aspx?un=UTD-61580

  18. Hot S, Egin S, Ilhan M, Bademler S, Dikker O, Aciksari K, et al. The value of potassium, pH and D-dimer levels in early diagnosis of acute mesenteric ischemia: an experimental study on rats. Arch Med Scien [Internet]. 2019 [citado 07 Dic 2020];15:1-5. Disponible en: https://pdfs.semanticscholar. org/0f9c/bf8d7faf09ca3344d0d6dd3a5c8d4bf30563.pdf?_ga=2.50268768.710415588.1607955993-2044273459.1607955993

  19. Tilsed JV, Casamassima A, Kurihara H, Mariani D, Casas I, Pereira J, et al. ESTES guidelines: acute mesenteric ischaemia. Eur J Trauma Emerg Surg. 2016;42:253-70.

  20. Canfora A, Ferronetti A, Marte G, Di Maio V, Mauriello C, Maida P, et al. Predictive factors of intes-tinal necrosis in acute mesenteric ischemia. Open Med. 2019;14:883-889. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947755/.

  21. Aliosmanoglu I, Gul M, Kapan M, Arikanoglu Z, Taskesen F, Basol Q, et al. Risk factors effecting mortality in acute mesenteric ischemia and mortality rates: a single center experience. Int Surg. 2013;98(1):76–81.

  22. Ranchordás S, Cunha C, Roque R, Féria L, Rui M. Acute mesenteric ischemia: a review of 50 cases. Int Surg J [Internet]. 2019 Jul [citado 07 Dic 2020];6(7):2272-2278. Disponible en: https://www.ijsurgery.com/index.php/isj/article/view/4144/2967

  23. Nuzzo A, Maggiori L, Ronot M, Becq A, Plessier A, Gault N, et al. Predictive factors of intestinal necrosis in acute mesenteric ischemia: prospective study from an intestinal stroke center. Am J Gas-troenterol. 2017 Apr;112(4):597-605.

  24. Del Río ML, González Fajardo JA, Vaquero Puerta C. Isquemia mesentérica aguda. Diagnóstico y tratamiento. Rev Angiología [Internet]. 2015 [citado 07 Dic 2020];67(2):133-139. Disponible en: https://www.elsevier.es/es-revista-angiologia-294-articulo-isquemia-mesenterica-aguda-diagnostico-tratamiento-S0003317014001631

  25. Rodríguez de la Calle J, Arroyo Bielsa A. Isquemia mesentérica aguda. En: Vaquero Morillo F, Cla-rá Velasco A, editores. Tratado de las enfermedades vasculares. Barcelona: Viguera Editores; 2006. p. 659-67.




2020     |     www.medigraphic.com