Renner, Philipp and Kienle, Klaus and Dahlke, Marc H. and Heiss, Peter and Pfister, Karin and Stroszczynski, Christian and Piso, Pompiliu and Schlitt, Hans J. (2011) Intestinal ischemia: current treatment concepts. LANGENBECKS ARCHIVES OF SURGERY, 396 (1). pp. 3-11. ISSN 1435-2443
Full text not available from this repository. (Request a copy)Abstract
Mesenteric ischemia is a condition well-known among physicians treating patients with abdominal symptoms. Even so, mortality rates have not decreased significantly over the last decades. The purpose of this article is to review current treatment concepts of acute and chronic mesenteric ischemia. Early diagnosis is one of the most important features that determine a patient's prognosis. Conventional angiography and multidetector computed tomography are therefore appropriate to quickly diagnose mesenteric ischemia, the latter being commonly more available. Once a patient presents with signs of peritonitis, instant laparotomy is indicated, and infarcted bowel segments need to be resected, followed by a second-look operation if necessary. If bowel necrosis is clinically not suspected, different approaches should be applied according to source and nature of mesenteric ischemia. Besides established surgical treatment concepts, more and more interventional procedures are developed and evaluated. However, superiority of these new techniques could only be shown for selected patient groups so far. In chronic mesenteric ischemia, interventional approaches seem to be an attractive alternative in patients who are in a condition too bad to undergo surgery. Patients with colonic ischemia are treated best in a conservative manner and by resolving the underlying cause, if identified. Patients with acute mesenteric ischemia are still at highest risk for a fatal course of disease. New diagnostic and therapeutic developments have not been tested in larger studies yet, neither has any of these methods led to an increased survival in studies published so far. Taken together, mesenteric ischemia requires high awareness, earliest possible diagnosis, and treatment by an experienced interdisciplinary team of gastroenterologists, radiologists, and surgeons.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | NONOCCLUSIVE MESENTERIC ISCHEMIA; ROW COMPUTED-TOMOGRAPHY; VENOUS THROMBOSIS; EARLY-DIAGNOSIS; THROMBOLYTIC THERAPY; PROGNOSTIC-FACTORS; ARTERY OCCLUSION; COLONIC ISCHEMIA; VEIN-THROMBOSIS; MANAGEMENT; Intestinal hypoxia; Acute mesenteric ischemia; Chronic mesenteric ischemia; Colonic ischemia |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Petra Gürster |
| Date Deposited: | 22 Apr 2020 06:44 |
| Last Modified: | 22 Apr 2020 06:44 |
| URI: | https://pred.uni-regensburg.de/id/eprint/21622 |
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