Presentation
We present four cases of acute mesenteric infarction in patients with active ulcerative colitis: one presenting prior to the diagnosis of ulcerative colitis, two at the time of diagnosis, and one many years after the diagnosis had been made. [ncbi.nlm.nih.gov]
Immune System
- Splenomegaly
No signs of bowel ischemia were noted, and the patient was treated successfully with long-term anticoagulation Associated findings that suggest MVT include bowel wall thickening, pneumatosis, splenomegaly, and ascites [ 39 ]. [wjes.biomedcentral.com]
Entire Body System
- Fever
A 69-year-old man with a history of gastrointestinal amyloidosis presented with fever and lethargy. [ncbi.nlm.nih.gov]
Patients may present with 1 : sudden onset of abdominal pain right lower quadrant pain and tenderness absence of fever and gastrointestinal symptoms encountered in healthy patients, such as marathoners, because of low omental blood flow Primary omental [radiopaedia.org]
None of our patients had fever at the beginning, although in other series of patients the authors point out that fever is as frequent as abdominal pain. 10 Zeier et al. reported that, aside from abdominal pain, most of their patients presented hematochezia [revistanefrologia.com]
Ileus as well as fever and diarrhoea appeared in 82% of patients [ 7, 10, 15 ]. In thirteen of our patients (87%), pain was present concomitantly with fever, guarding and hyperleucocytosis. [academic.oup.com]
Clinical manifestations, such as fever, diarrhea and leukocytosis, are nonspecific, which makes early diagnosis of NOMI very difficult. [kjim.org]
- Severe Pain
The most important finding is moderate to severe pain that, upon examination, has no obvious cause. The pain is diffuse, nonlocalized, and constant. Acute Mesenteric Ischemia often presents with sudden and severe abdominal pain. [diagnose-me.com]
Her physical exam is normal, including vital signs, but she continues to complain of severe pain. [epmonthly.com]
With acute mesenteric ischemia, you may have sudden, severe stomach pain. Narcotic pain medications may not adequately alleviate the pain that is associated with mesenteric ischemia. [indiahospitaltour.com]
Specialty Vascular surgery, gastroenterology Symptoms Acute : sudden severe pain [1] Chronic : abdominal pain after eating, unintentional weight loss, vomiting [2] [1] Usual onset > 60 years old [3] Types Acute, chronic [1] Risk factors Atrial fibrillation [en.wikipedia.org]
- Pathologist
Two pathologists at separate institutions examined the pathology from the LV mass biopsy and confirmed the diagnosis of cardiac sarcoma. [acgcasereports.gi.org]
Gastrointestinal
- Abdominal Pain
In particular they were more likely to have abdominal pain and distention and less likely to be confused. [ncbi.nlm.nih.gov]
Presentation Symptoms sudden onset of severe abdominal pain abdominal pain after eating ("intestinal angina") if due to arterial thrombosis nausea vomiting diarrhea mild GI bleeding Physical exam abdominal pain out of proportion to physical findings [medbullets.com]
- Vomiting
You may also experience nausea, vomiting, diarrhea or flatulence. WEIGHT LOSS CHRONIC mesenteric ischemia sometimes leads you to lose weight because, although you may feel hungry, you eat less or less frequently to avoid the pain. [vascular.org]
The other 3 patients experienced shock and metabolic acidosis. white blood cell count over 10.5 – 98% lactic acid elevated – 91% nausea – 44% (other surveys have found nausea and vomiting in 75% of affected patients) vomiting – 35% diarrhea – 35% heart [diagnose-me.com]
Critical Essential Core Tested Community Questions (2) (M2.GI.74) A 68-year-old male smoker with a history of peripheral vascular disease and a below the knee amputation, presents to the emergency room with excruciating abdominal pain and vomiting for [medbullets.com]
[…] of ruptured abdominal aortic aneurysm: (1) Abdominal pain, (2) Pulsatile abdominal mass, (3) Hypotension Classic triad for acute mesenteric ischemia: (1) Acute onset of abdominal pain which is classically out of proportion to the physical exam, (2) Vomiting [theweeklymnemonic.wordpress.com]
Clinical presentation is classically that of acute onset of severe periumbilical pain that is out of proportion to physical exam findings, +/- nausea/vomiting. Peritoneal signs and sepsis indicate bowel infarction. [errolozdalga.com]
- Acute Abdomen
Although Takayasu's arteritis may present a wide variety of signs and symptoms depending on the vessel affected, it is rarely associated with acute abdomen requiring emergency laparotomy. [ncbi.nlm.nih.gov]
CLINICAL AND SEROLOGIC MARKERS, WERE EXAMINED FOR STATISTICAL DIFFERENCE IN PATIENTS WITH ACUTE ABDOMEN FROM INTESTINAL ISCHAEMIA. [didaktorika.gr]
- Severe Abdominal Pain
How Ohio State diagnoses mesenteric ischemia If you have sudden severe abdominal pain, you may have acute mesenteric ischemia or other abdominal problems, and should go to an emergency room immediately. [wexnermedical.osu.edu]
Presentation Symptoms sudden onset of severe abdominal pain abdominal pain after eating ("intestinal angina") if due to arterial thrombosis nausea vomiting diarrhea mild GI bleeding Physical exam abdominal pain out of proportion to physical findings [medbullets.com]
Symptoms caused by gradual hardening of the mesenteric arteries: Abdominal pain after eating Diarrhea Symptoms of sudden (acute) mesenteric artery ischemia due to a traveling blood clot include: Sudden severe abdominal pain Diarrhea Vomiting When symptoms [medlineplus.gov]
Ischemia in the small intestine interferes with digestion and can cause severe abdominal pain. [hopkinsmedicine.org]
The most important finding is moderate to severe pain that, upon examination, has no obvious cause. The pain is diffuse, nonlocalized, and constant. Acute Mesenteric Ischemia often presents with sudden and severe abdominal pain. [diagnose-me.com]
- Abdominal Distension
On the 14th hospital day, the developing abdominal distension and generalized tenderness suggested a mesenteric vascular occlusion. Following abdominal aortography, emergency surgery was performed. [ncbi.nlm.nih.gov]
However, he developed acute small bowel obstruction as shown by increasing abdominal pain, left iliac fossa tenderness, abdominal distension, faeculent vomiting, obstructive bowel sounds, and dilated small bowel loops on abdominal radiography. [pmj.bmj.com]
As the disease progresses and the bowel infarcts and the patient will develop abdominal distension with guarding, rebound, and absence of bowel sounds. They may develop abdominal wall rigidity. [cdemcurriculum.com]
There may be bloody diarrhoea and often fever and abdominal distension. The patient usually is not grossly ill or shocked. Investigations Laboratory tests and angiography usually are not helpful. [surgwiki.com]
Some patients will have hypoactive bowel sounds and abdominal distension. Guiaic positive stool are also seen but may also manifest as frank hematochezia. [clinicaladvisor.com]
Musculoskeletal
- Contusion
In literature, the posttraumatic etiology is found in a small number compared to the large number of abdominal contusion, intimal lesional factor beeing associated with blood thickness. [ncbi.nlm.nih.gov]
Skin
- Flushing
Second, the specific anatomy of the culprit lesion(s) (e.g., the angle of vessel branching from the aorta, presence of flush ostial occlusion, occluded stent, etc.) must be amenable to a percutaneous approach. [acc.org]
Association guidelines give EVT and surgery equal weighting in the treatment of CMI (class I, level of evidence B). 13 Surgery is utilized for patients who are considered low risk with unfavorable anatomy for EVT, as well as for failed EVT because of flush [evtoday.com]
Neurologic
- Headache
He was on intermittent catheterisation, had a history of bladder hyper-reflexia with some episodes of symptomatic urinary tract infections, of mild autonomic dysreflexia (headache, sweating) on high bladder distension, of mild orthostatic hypotension, [nature.com]
You should seek medical help immediately if you have: pain in your chest or lower back a severe headache irregular heartbeat difficulty breathing double vision difficulty with speech or movement unconsciousness lasting longer than one minute Most cases [healthline.com]
Workup
Although we pointed out the limitations of CT-scan, we keep thinking that it should remain the cornerstone of the diagnostic workup of AMI in the ICU. [annalsofintensivecare.springeropen.com]
A head computerized tomography (CT) scan may also be needed as part of the workup of a seizure disorder. [ncbi.nlm.nih.gov]
Laboratory
- Leukocytosis
Laboratory studies of value include evidence of hemoconcentration and leukocytosis. Roentgenographic findings are equally nonspecific unless late in the course. Recommended operative procedures depend on the etiology of the infarction. [ncbi.nlm.nih.gov]
Clinical manifestations, such as fever, diarrhea and leukocytosis, are nonspecific, which makes early diagnosis of NOMI very difficult. [kjim.org]
Nonspecific laboratory findings include leukocytosis, elevated lactate, hemoconcentration, and metabolic acidosis. [acgcasereports.gi.org]
Leukocytosis often raises concerns about appendicitis, cholecystitis, or diverticulitis rather than mesenteric ischemia. A high WBC count is again nonspecific i.e. it can be elevated in a number of other conditions. [emdidactic.blogspot.com]
Treatment
Abstract The clinical features, the treatment given, the factors governing treatment selection, and the result of such treatment were analyzed in all patients aged 65 years and over in whom a tissue diagnosis of acute mesenteric infarction was made at [ncbi.nlm.nih.gov]
Although surgical resection of the necrotic bowel is the treatment of choice, the patient and her family opted for conservative treatment. The patient died 3 days later. [nejm.org]
Prognosis
Patients with primary venous mesenteric infarction showed a better survival rate (one death in eight patients) than patients with associated diseases such as liver cirrhosis, sepsis or previous operation who had a poor prognosis with a mortality comparable [ncbi.nlm.nih.gov]
Complications such as peritonitis and sepsis result in a poor prognosis. [amboss.com]
Microphthalmos with cyst had the worst prognosis, coloboma with microcornea and microphthalmos a poor prognosis, coloboma with only microcornea had an intermediate prognosis, and simple coloboma had the best prognosis. [aao.org]
Prognosis In cases of mesenteric artery ischemia, prognosis is especially poor if the patient is not treated quickly. Even with treatment the risk of death is 30-90%, depending on the stage at which treatment is started. [diagnose-me.com]
Etiology
Abstract The most common etiologies of mesenteric infarction in fifty-one patients were arterial thrombosis (in 42 per cent), bowel infarction without major vessel occlusion (in 28 per cent), and arterial embolus (in 22 per cent), but the etiology also [ncbi.nlm.nih.gov]
Epidemiology
The descriptive epidemiology of anophthalmia and microphthalmia. Int J Epidemiol. 1996;25:1009–1016. ↑ 8.0 8.1 Forrester MB, Merz RD. Descriptive epidemiology of anophthalmia and microphthalmia, Hawaii, 1986–2001. [eyewiki.aao.org]
Pathophysiology
Pathophysiology Intestinal blood flow of the superior mesenteric artery (SMA) and/or inferior mesenteric artery (IMA) is suddenly compromised (see “Etiology” for causes) → intestinal hypoxia → intestinal wall damage → mucosal inflammation + possibly bleeding [amboss.com]
Internal Medicine (85) Physiology and Pathophysiology (79) Cardiology, Angiology (72) Paediatrics, Neonatology (53) Medical Chemistry and Biochemistry (47) Pathology and Forensic Medicine (44) Surgery, Traumatology and Orthopaedics (27) Neurology (21) [portal.mefanet.cz]
This discussion will focus on the etiology, pathophysiology, diagnosis, and management of acute mesenteric ischemia. Table 86–1. Potential Causes of Acute Mesenteric Ischaemia [accessmedicine.mhmedical.com]
In Gastrointestinal Diseases: Pathophysiology, Diagnosis, Management, Sleisenger, M.H., Fordtran, J.S., editors. Philadelphia-London-Toronto, W.B. Saunders Company, 1973, p. 1560 Google Scholar 17. [link.springer.com]
Overview The author explains the clinical presentation, pathophysiology, diagnostic work-up, and management of micturition and defecation syncopes. Micturition syncope is a fairly common disorder that generally occurs in men. [medlink.com]
Prevention
In view of the high recurrence rate in the early postoperative period, treatment must prevent the causes of persistent or recurrent ischaemia such as vasoconstriction and reperfusion tissue damage. [ncbi.nlm.nih.gov]
ACE inhibitors also prevent conversion of angiotensin I to angiotensin II (a potent vasoconstrictor), thus reducing afterload to help prevent heart failure. [medical-dictionary.thefreedictionary.com]
Prevention of micturition syncope depends on recognizing the factors that contribute to micturition syncope and avoiding them. [drugs.com]
CHICAGO – Early recognition of mesenteric ischemia in young adults and children is essential to prevent bowel loss and other serious consequences associated with this rare condition, Dr. Michael Dalsing said at a vascular surgery symposium. [mdedge.com]