Akute intestinale Ischämie
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Akute intestinale Ischämie. / Debus, E S; Diener, H; Larena-Avellaneda, A.
In: CHIRURG, Vol. 80, No. 4, 04.2009, p. 3753-85.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Akute intestinale Ischämie
AU - Debus, E S
AU - Diener, H
AU - Larena-Avellaneda, A
PY - 2009/4
Y1 - 2009/4
N2 - Etiologically, therapeutically and prognostically, acute mesenteric ischemia is distinguished from chronic splanchnic ischemia. Acute mesenteric ischemia always is a case of emergency and associated with a 60-80% lethality. Difficult diagnosis, combined rapid progression of ischemic tissue loss and bacterial translocation are the main reasons for this depressing situation. Furthermore, obvious deficits in management and professional treatment are concomitant reasons. Only by intervening these factors prognosis of this deleting disease can be optimized.The main vessel, causing symptoms in 85%, is the superior mesenteric artery. Severe courses are characterized by abdominal rest pain and tissue lesions. In all symptomatic cases we see an indication for invasive treatment. CT-angiography with 3D-reconstruction is the diagnostic tool of choice. Today, conventional angiography only plays a role in combination with endovascular treatment (catheter-derived infusion therapy, lysis, PTA, stent). Duplex sonography should be performed, since this technique reveals relevant insight in hemodynamic severity of the lesion. However, diagnostic accuracy often is restricted due to air-filled bowels.
AB - Etiologically, therapeutically and prognostically, acute mesenteric ischemia is distinguished from chronic splanchnic ischemia. Acute mesenteric ischemia always is a case of emergency and associated with a 60-80% lethality. Difficult diagnosis, combined rapid progression of ischemic tissue loss and bacterial translocation are the main reasons for this depressing situation. Furthermore, obvious deficits in management and professional treatment are concomitant reasons. Only by intervening these factors prognosis of this deleting disease can be optimized.The main vessel, causing symptoms in 85%, is the superior mesenteric artery. Severe courses are characterized by abdominal rest pain and tissue lesions. In all symptomatic cases we see an indication for invasive treatment. CT-angiography with 3D-reconstruction is the diagnostic tool of choice. Today, conventional angiography only plays a role in combination with endovascular treatment (catheter-derived infusion therapy, lysis, PTA, stent). Duplex sonography should be performed, since this technique reveals relevant insight in hemodynamic severity of the lesion. However, diagnostic accuracy often is restricted due to air-filled bowels.
KW - Acute Disease
KW - Anastomosis, Surgical/methods
KW - Angiography, Digital Subtraction
KW - Angioplasty, Balloon
KW - Aortography
KW - Emergencies
KW - Gangrene
KW - Humans
KW - Image Processing, Computer-Assisted
KW - Imaging, Three-Dimensional
KW - Intestines/blood supply
KW - Ischemia/diagnosis
KW - Mesenteric Artery, Superior
KW - Mesenteric Vascular Occlusion/diagnosis
KW - Necrosis
KW - Postoperative Complications/etiology
KW - Prognosis
KW - Reoperation
KW - Stents
KW - Survival Rate
KW - Tomography, X-Ray Computed
KW - Ultrasonography
U2 - 10.1007/s00104-009-1699-7
DO - 10.1007/s00104-009-1699-7
M3 - SCORING: Zeitschriftenaufsatz
C2 - 19350311
VL - 80
SP - 3753
EP - 3785
JO - CHIRURG
JF - CHIRURG
SN - 0009-4722
IS - 4
ER -
