| Death by midgut infarction: clinical lessons from 88 post-mortems in Auckland, New Zealand. | |
| | |
MedLine Citation:
|
PMID: 19183377 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Mortality rates from acute arterial mesenteric ischaemia remain high. Early diagnosis is of prognostic importance; however, early features are often non-specific, necessitating a high index of suspicion and knowledge of the at-risk patient. This study reviewed three decades of fatal cases in Auckland, New Zealand, to identify risk factors and associated pathologies that might help guide early diagnosis. Diagnostic delay was also evaluated. METHODS: Cases were identified through a pathology database maintained from 1977 to 2006. Autopsy reports were assessed together with available clinical detail. RESULTS: Eighty-eight cases were recovered. Mean age was 75.4 years, with women predominating (57%). Thromboembolic occlusion was the leading cause, followed by thrombotic occlusion. Embolic sources included atrial disease, aortic disease and myocardial infarction. Patients routinely showed extensive comorbidities, especially cardiovascular. Pain was the most constant presenting symptom, but features were often subtle and clinicians frequently misdiagnosed more minor ailments. Of operated patients, 36% received operations within 6 h of admission, 33% within 24 h, 17% at between 1 and 2 days, and the remainder between 2 and 12 days. CONCLUSION: Knowledge of risk factors defined here is important to guide early diagnosis of mesenteric ischaemia. Diagnostic delay is again shown to be significant and case experience gathered in this series may improve doctors' discernment when meeting this condition. |
| | |
Authors:
|
Gregory O'Grady; Shanu Ghambir; Timothy D Koelmeyer |
Related Documents
:
|
14617547 - Sources of diagnostic inaccuracy of conventional versus new diagnostic criteria for myo... 18067687 - Multiple microvessels extending from the coronary arteries to the left ventricle in a m... 16371767 - Acute coronary syndrome after infliximab infusion. 9024917 - Status of chest x-ray in diagnosing right ventricular infarction. 2485907 - Comparative studies of doxorubicin and 4'-epidoxorubicin effects on cardiovascular syst... 1653847 - The role of serotonin (5ht2) receptor blockade in myocardial reperfusion injury: effect... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: ANZ journal of surgery Volume: 79 ISSN: 1445-2197 ISO Abbreviation: ANZ J Surg Publication Date: 2009 Jan-Feb |
Date Detail:
|
Created Date: 2009-02-02 Completed Date: 2009-05-08 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101086634 Medline TA: ANZ J Surg Country: Australia |
Other Details:
|
Languages: eng Pagination: 38-41 Citation Subset: IM |
Affiliation:
|
Department of Forensic Pathology, University of Auckland, Auckland, New Zealand. gog@ps.gen.nz |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Aged, 80 and over Comorbidity Female Humans Male Mesenteric Arteries* Mesenteric Vascular Occlusion / diagnosis*, etiology, mortality, surgery Middle Aged New Zealand / epidemiology Prognosis Retrospective Studies Risk Factors Splanchnic Circulation* Thromboembolism / complications Thrombosis / complications |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Defining the role of surgery for complications after pancreatoduodenectomy.
Next Document: Functional impairment after latissimus dorsi flap.