Patología vascular mesentérica

  1. Irene Peñas Herrero 1
  2. Rebeca Pintado Garrido 2
  3. Isabel San José Crespo 1
  4. Carolina Almohalla Álvarez 1
  1. 1 Unidades de Hepatología, Hospital Universitario Río Hortega, Valladolid, España
  2. 2 Unidades de Radiología vascular, Hospital Universitario Río Hortega, Valladolid, España
Journal:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Year of publication: 2024

Issue Title: Enfermedades del aparato digestivo (XII) Patología peritoneal, portal y mesentérica

Series: 14

Issue: 12

Pages: 672-690

Type: Article

DOI: 10.1016/J.MED.2024.06.004 DIALNET GOOGLE SCHOLAR

More publications in: Medicine: Programa de Formación Médica Continuada Acreditado

Abstract

Mesenteric vascular disease is wide-ranging and can produce different manifestations depending on various factors, including the presence of symptoms or not; the clinical form of presentation; the vessels involved, duration, and cause; and collateral blood flow. The clinical entities described herein include acute and chronic mesenteric artery ischemia; nonocclusive mesenteric ischemia; acute, subacute, and chronic mesenteric venous thrombosis; focal segmental ischemia of the small intestine; colonic ischemia; arterial aneurysms; and vasculitis. This disease produces a wide spectrum of clinical symptoms that share the same predisposing factors and many etiologies, although with different consequences. Abdominal pain is the most common clinical symptom in these diseases. In acute forms, high clinical suspicion is essential for making a rapid diagnosis and early treatment that prevents more severe lesions. The widespread use of computed tomography has led to greater diagnostic rates with an improved prognosis for these patients. Treatment varies from conservative to surgical, depending on the case. Early anticoagulation is a fundamental treatment in many cases and in recent years, vascular radiology techniques have been developed which produce good results.

Bibliographic References

  • 1. M.L. Del Río Solá et al. Acute mesenteric ischemia. Diagnosis and treatment. Angiologia. (2015)
  • 2. R. Navas-Campo et al. Acute mesenteric ischemia: a review of the main imaging techniques and signs. Radiologia. (2020)
  • 3. M. Björck et al. Editor's Choice – Management of the diseases of mesenteric arteries and veins: Clinical practice guidelines of the European Society of Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. (2017)
  • 4. P. Sardar et al. Chronic mesenteric ischemia: Diagnosis and management. Prog Cardiovasc Dis. (2021)
  • 5. T.S. Huber et al. Chronic mesenteric ischemia: Clinical practice guidelines from the Society for Vascular Surgery. J Vasc Surg. (2021)
  • 6. G.S. Oderich et al. Comparison of covered stents versus bare metal stents for treatment of chronic atherosclerotic mesenteric arterial disease. J Vasc Surg. (2013)
  • 7. A.K. Pillai et al. Quality improvement guidelines for mesenteric angioplasty and stent placement for the treatment of chronic mesenteric ischemia. J Vasc Interv Radiol. (2018)
  • 8. S. Abu-Daff et al. Mesenteric venous thrombosis and factors associated with mortality: A statistical analysis with five-year follow-up. J Gastrointest Surg. (2009)
  • 9. P. Demelo-Rodríguez et al. Trombosis venosa mesentérica. Med Clin. (2023)
  • 10. U. Amaravathi et al. Superior mesenteric arterial and venous thrombosis in COVID-19. J Emerg Med. (2021)
  • 11. J.F. McKinsey et al. Acute mesenteric ischemia. Surg Clin North Am. (1997)
  • 12. D.W. Orr et al. Chronic mesenteric venous thrombosis: Evaluation and determinants of survival during long-term follow-up. Clin Gastroenterol Hepatol. (2007)
  • 13. S. Yang et al. Postoperative catheter-directed thrombolysis versus systemic anticoagulation for acute superior mesenteric venous thrombosis. Ann Vasc Surg [Internet]. (2016)
  • 14. B. Hmoud et al. Mesenteric venous thrombosis. J Clin Exp Hepatol. (2014)
  • 15. Singal et al. Mesenteric venous thrombosis. Mayo Clin Proc. (2013)
  • 16. E.V. Loftus et al. Incidence of ischemic colitis in Olmsted County, Minnesota, 1976-1998. Am J Gastroenterol. (2002)
  • 17. T.G. Cotter et al. Colon ischemia an update for clinicians. Mayo Clin Proc. (2016)
  • 18. W. Lucas et al. Reversible ischemic colitis in a high endurance athlete. Am J Gastroenterol. (1998)
  • 19. L.D. Sánchez et al. Ischemic colitis in marathon runners: A case-based review. J Emerg Med. (2006)
  • 20. B.J. Champagne et al. Incidence of colonic ischemia after repair of ruptured abdominal aortic aneurysm with endograft. J Am Coll Surg. (2007)
  • 21. C. Flobert et al. Right colonic involvement is associated with severe forms of ischemic colitis and occurs frequently in patients with chronic renal failure requiring hemodialysis. Am J Gastroenterol. (2000)
  • 22. S. Erguney et al. Passage of «colonic cast» after colorectal surgery: Report of four cases and review of the literature. J Gastrointest Surg. (2007)
  • 23. T.H. Su et al. The passage of a colonic cast. Lancet. (2010)
  • 24. B.S. Ullery et al. Colonic ischemia: An under-recognized cause of lower gastrointestinal bleeding. J Emerg Med. (2004)
  • 25. S. Romano et al. Multidetector row computed tomography findings from ischemia to infarction of the large bowel. Eur J Radiol. (2007)
  • 26. S. Mitsudo et al. Pathology of intestinal ischemia. Surg Clin North Am. (1992)
  • 27. T. Houe et al. Can colonoscopy diagnose transmural ischaemic colitis after abdominal aortic surgery? An evidence-based approach. Eur J Vasc Endovasc Surg. (2000)
  • 28. G. Zuckerman et al. The colon single-stripe sign and its relationship to ischemic colitis. Am J Gastroenterol. (2003)
  • 29. M. Huguier et al. Ischemic colitis. Am J Surg. (2006)
  • 30. I.E. Koutroubakis et al. Role of acquired and hereditary thrombotic risk factors in colon ischemia of ambulatory patients. Gastroenterology. (2001)
  • 31. A. Theodoropoulou et al. Genetic risk factors in young patients with ischemic colitis. Clin Gastroenterol Hepatol. (2008)
  • 32. S.F. Pasha et al. Splanchnic artery aneurysms. Mayo Clin Proc. (2007)
  • 33. M. Ahmed. Ischemic bowel disease in 2021. World J Gastroenterol. (2021)
  • 34. A. Savlania et al. Acute mesenteric ischemia: Current multidisciplinary approach. J Cardiovasc Surg (Torino). (2017)
  • 35. H. Yu et al. An update on acute mesenteric ischemia. Can Assoc Radiol J. (2023)
  • 36. H. Fuglseth et al. Acute mesenteric ischaemia. Br J Surg. (2023)
  • 37. M.M. Monita et al. Acute mesenteric ischemia. 2023. En: StatPearls [Internet] (2024)
  • 38. J.M. Kärkkäinen. Acute mesenteric ischemia: A challenge for the acute care surgeon. Scand J Surg. (2021)
  • 39. Van Dijk et al. Clinical management of chronic mesenteric ischemia. United Eur Gastroenterol J. (2019)
  • 40. L.G. Terlouw et al. European guidelines on chronic mesenteric ischaemia – joint United European Gastroenterology, European Association for Gastroenterology, Endoscopy and Nutrition, European Society of Gastrointestinal and Abdominal Radiology, Netherlands Association of Hepa. United Eur Gastroenterol J. (2020)
  • 41. S. Bourcier et al. Non-occlusive mesenteric ischemia: Diagnostic challenges and perspectives in the era of artificial intelligence. World J Gastroenterol. (2021)
  • 42. B. Yu et al. Non-occlusive mesenteric ischemia in critically ill patients. PLoS One. (2022)
  • 43. M. Bala et al. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. World J Emerg Surg. (2022)
  • 44. D.A. Simonetto et al. ACG Clinical Guideline: Disorders of the hepatic and mesenteric circulation. Am J Gastroenterol. (2020)
  • 45. P. Feuerstadt et al. Intestinal ischemia. En: Sleisenger and Fordtran's Gastrointestinal and Liver disease. (2021)
Data source: Dialnet