| Diagnosis and treatment of nonocclusive mesenteric ischemia after open heart surgery. | |
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MedLine Citation:
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PMID: 11722048 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Acute nonocclusive mesenteric ischemia (NOMI) is a rare but often fatal event after cardiac surgery. METHODS: Twenty patients with ongoing ileus after cardiac surgery despite maximal laxative treatment underwent selective mesenteric angiography. In cases of pathological radiographic findings, papaverine was continuously administered via an intraarterial perfusion catheter. RESULTS: Severe NOMI was confirmed in seven patients (mean lactate: 6.9 +/- 8.3 mg/dL), mild to moderate findings in another seven (mean lactate: 1.4 +/- 1.1 mg/dL). One patient had thromboembolic occlusion of the superior mesenteric artery; five patients demonstrated normal imaging findings. In nine of fourteen patients (64%) treated with papaverine, symptoms improved within hours (defecation occurred after 4-29 hours, mean 13 +/- 8.1 hours). No side effects or complications occurred in connection with the papaverine treatment. The clinical condition of five patients deteriorated. Four patients underwent laparotomy with creation of an ileostomy or colostomy, two of whom presented with severe intestinal ischemia and later died. One patient died prior to laparotomy. CONCLUSIONS: Selective mesenteric angiography with continuous papaverine administration is a simple, fast, and effective diagnostic and therapeutic tool to reduce the need for laparotomy for symptoms of ileus after open-heart surgery. |
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Authors:
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S Klotz; T Vestring; J Rötker; C Schmidt; H H Scheld; C Schmid |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 72 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2001 Nov |
Date Detail:
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Created Date: 2001-11-27 Completed Date: 2002-01-31 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1583-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiothoracic Surgery, University Hospital of Münster, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac Surgical Procedures / adverse effects* Female Humans Infusions, Intra-Arterial Ischemia / drug therapy*, etiology, radiography* Male Mesenteric Arteries / radiography* Papaverine / administration & dosage* Severity of Illness Index Vasodilator Agents / administration & dosage* |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 58-74-2/Papaverine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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