| Diagnosis and management of splanchnic ischemia. | |
| | |
MedLine Citation:
|
PMID: 19109864 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Splanchnic or gastrointestinal ischemia is rare and randomized studies are absent. This review focuses on new developments in clinical presentation, diagnostic approaches, and treatments. Splanchnic ischemia can be caused by occlusions of arteries or veins and by physiological vasoconstriction during low-flow states. The prevalence of significant splanchnic arterial stenoses is high, but it remains mostly asymptomatic due to abundant collateral circulation. This is known as chronic splanchnic disease (CSD). Chronic splanchnic syndrome (CSS) occurs when ischemic symptoms develop. Ischemic symptoms are characterized by postprandial pain, fear of eating and weight loss. CSS is diagnosed by a test for actual ischemia. Recently, gastro-intestinal tonometry has been validated as a diagnostic test to detect splanchnic ischemia and to guide treatment. In single-vessel CSD, the complication rate is very low, but some patients have ischemic complaints, and can be treated successfully. In multi-vessel stenoses, the complication rate is considerable, while most have CSS and treatment should be strongly considered. CT and MR-based angiographic reconstruction techniques have emerged as alternatives for digital subtraction angiography for imaging of splanchnic vessels. Duplex ultrasound is still the first choice for screening purposes. The strengths and weaknesses of each modality will be discussed. CSS may be treated by minimally invasive endoscopic treatment of the celiac axis compression syndrome, endovascular antegrade stenting, or laparotomy-assisted retrograde endovascular recanalization and stenting. The treatment plan is highly individualized and is mainly based on precise vessel anatomy, body weight, co-morbidity and severity of ischemia. |
| | |
Authors:
|
Jeroen-J Kolkman; Marloes Bargeman; Ad-B Huisman; Robert-H Geelkerken |
Related Documents
:
|
12271384 - Clinical results of carotid artery stenting with a nitinol self-expanding stent (smart ... 8933984 - The v-stent: a novel technique for coronary bifurcation stenting. 8921774 - Effects of endovascular radiation from a beta-particle-emitting stent in a porcine coro... 2398204 - Foam-rubber stents for skin grafts. 22427314 - Left hemitruncus with tetralogy of fallot and right aortic arch: rare survival beyond t... 21660234 - Pulmonary hypertension related to left-sided cardiac pathology. |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: World journal of gastroenterology : WJG Volume: 14 ISSN: 1007-9327 ISO Abbreviation: World J. Gastroenterol. Publication Date: 2008 Dec |
Date Detail:
|
Created Date: 2008-12-25 Completed Date: 2009-05-19 Revised Date: 2010-09-23 |
Medline Journal Info:
|
Nlm Unique ID: 100883448 Medline TA: World J Gastroenterol Country: China |
Other Details:
|
Languages: eng Pagination: 7309-20 Citation Subset: IM |
Affiliation:
|
Department of Gastroenterology, Medisch Spectrum Twente, 7500 KA Enschede, The Netherlands. j.kolkman@mst.nl |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Angiography Humans Ischemia / diagnosis*, therapy* Severity of Illness Index Splanchnic Circulation / physiology Ultrasonography, Doppler, Duplex Vascular Surgical Procedures Viscera / blood supply*, radiography, ultrasonography |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Ischemic colitis: clinical practice in diagnosis and treatment.
Next Document: Scutellaria barbate extract induces apoptosis of hepatoma H22 cells via the mitochondrial pathway in...