Document Detail


Occlusive and non-occlusive gastrointestinal ischaemia: a clinical review with special emphasis on the diagnostic value of tonometry.
MedLine Citation:
PMID:  9515745     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To review clinical features of the occlusive splanchnic ischaemia syndromes with special emphasis on the diagnostic value of tonometry. METHODS: The English literature was reviewed with an emphasis on papers concerning anatomy and physiology of splanchnic perfusion, the clinical presentation and diagnostic procedures in occlusive splanchnic ischaemia syndromes. RESULTS: Splanchnic ischaemia can result from hypovolaemic states, resulting in splanchnic vasoconstriction and ischaemia with normal splanchnic vessels (non-occlusive ischaemia) or from vascular stenoses (occlusive ischaemia). The former is frequently encountered in critically ill patients, whereas the latter is considered rare, despite a relatively high incidence of splanchnic atherosclerosis. The main problem hindering assessment of the incidence of symptomatic chronic splanchnic ischaemia is the lack of a diagnostic procedure separating symptom-free from symptomatic splanchnic atherosclerosis. Although angiography provides precise anatomical information, the correlation with symptoms is poor. From various studies it emerges that tonometry of luminal PCO2 enables assessment of ischaemia. CONCLUSIONS: Splanchnic ischaemia may be more common than currently assumed, but a gold standard diagnostic tool is lacking. Tonometry of the gastric PCO2 may be the most promising technique for detecting and grading splanchnic ischaemia.
Authors:
J J Kolkman; A B Groeneveld
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Scandinavian journal of gastroenterology. Supplement     Volume:  225     ISSN:  0085-5928     ISO Abbreviation:  Scand. J. Gastroenterol. Suppl.     Publication Date:  1998  
Date Detail:
Created Date:  1998-05-14     Completed Date:  1998-05-14     Revised Date:  2008-02-13    
Medline Journal Info:
Nlm Unique ID:  0437034     Medline TA:  Scand J Gastroenterol Suppl     Country:  NORWAY    
Other Details:
Languages:  eng     Pagination:  3-12     Citation Subset:  IM    
Affiliation:
Dept. of Gastroenterology, Medical Spectrum Twente, Enschede, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Arteriosclerosis / diagnosis
Carbon Dioxide / analysis*
Diagnosis, Differential
Humans
Hypercapnia / metabolism
Intestines / blood supply*
Ischemia* / diagnosis,  etiology,  physiopathology,  therapy
Mesenteric Vascular Occlusion* / diagnosis,  etiology,  physiopathology,  therapy
Splanchnic Circulation*
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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