Mesenteric Vessel Thrombosis Treatment Experience

Vladimir Beloborodov; Vladimir Vorobev; Svetlana Sokolova; Aleksandr Frolov; Denis Kornilov; Ludmila Sorokina; Igor Golub

doi:10.3889/oamjms.2021.6435

Authors

Vladimir Beloborodov Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russia
Vladimir Vorobev Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russia https://orcid.org/0000-0001-6813-7060
Svetlana Sokolova Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russia
Aleksandr Frolov Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russia
Denis Kornilov Department of Traumatology, Orthopedics and Neurosurgery, ISMAPgE – Branch Campus of the FSBEI FPE RMACPE MOH Russia, Irkutsk, Russia
Ludmila Sorokina Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russia
Igor Golub Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russia

DOI:

https://doi.org/10.3889/oamjms.2021.6435

Keywords:

Intestinal ischemia, Intestinal necrosis, Mesenteric vessel thrombosis, Non-occlusive thrombosis, Occlusive thrombosis

Abstract

BACKGROUND: One of the most serious diseases among all emergency abdominal pathology is an acute violation of the mesenteric blood circulation. The rapid development of intestinal ischemia results in its infarction and necrosis.

AIM: The study aims to assess the survival rate of patients with mesenteric vascular thrombosis, taking into account, the predictor characteristics influence of disease development factors.

METHODS: The study presents a retrospective analysis of mesenteric vascular thrombosis clinical cases for 2016–2019. During this period, there were 147 patients with an established diagnosis at the Irkutsk Clinical Hospital No. 1, 21 of them met the study criteria.

RESULTS: According to the type of thrombosis, there were two groups – occlusive (Group I, n = 11) and non occlusive (Group II, n = 10). Four patients (36.3%) of Group I and 7 patients (70%) of Group II (p = 0.388) recovered from the disease. Three patients (27.2%) of Group I and 4 patients (40%) of Group II (p = 0.662) received conservative therapy, 2 of them (66.6%) in Group I and 4 (100%) in Group II (p = 0.724) recovered from the disease. In addition, the authors performed a mortality assessment, according to the timing of the visit to a medical institution. Four (50%) out of eight patients who applied in the first 12 h, 2 (66%) out of three – in the first 12–24 h, and 5 (50%) out of 10 for more than 24 h of illness had a positive treatment result in the combined group.

CONCLUSION: The patients over 70 years old with peritoneal symptoms and established intestinal necrosis have an extremely unfavorable prognosis. The primary mesenteric vessel thrombosis with additional contrast angiography still gives a moderate treatment prognosis.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Acosta S. Epidemiology of mesenteric vascular disease: Clinical implications. Semin Vasc Surg. 2010;23(1):4-8. PMid:20298944 DOI: https://doi.org/10.1053/j.semvascsurg.2009.12.001

РОХ. Acute Mesenteric Ischemia. National Clinical Guidelines APR 6. Available from: http://www.xn----9sbdbejx7bdduahou3a5d.xn--p1ai/stranica-pravlenija/klinicheskie-rekomendaci/ostraja-mezenterialnaja-ishemija-nkr.html;2018. [Last accessed on 2021 Jan 12].

Tilsed JV, Casamassima A, Kurihara H, Mariani D, Martinez I, Pereira J, et al. ESTES guidelines: Acute mesenteric ischemia. Eur J Trauma Emerg Surg. 2016;42(2):253-70. https://doi.org/10.1007/s00068-016-0634-0 PMid:26820988 DOI: https://doi.org/10.1007/s00068-016-0634-0

Haga Y, Odo M, Homma M, Komiya K, Takeda K, Koike S, et al. New prediction rule for mortality in acute mesenteric ischemia. Digestion. 2009;80(2):104-11. https://doi.org/10.1159/000219367 PMid:19556795 DOI: https://doi.org/10.1159/000219367

Krichevskaya GI, Slepova OS, Sahakyan SV, Myakoshina EB, Denisova YV. On the role of infections in the pathogenesis of retinoblastoma. Russ Ophthalmol J. 2013;6(2):37-40.

Berland T, Oldenburg WA. Acute mesenteric ischemia. Curr Gastroenterol Rep. 2008;10:341-6. https://doi.org/10.1007/s11894-008-0065-0 DOI: https://doi.org/10.1007/s11894-008-0065-0

Tsai MS, Lin CL, Chen HP, Lee PH, Sung FC, Kao CH. Long-term risk of mesenteric ischemia in patients with inflammatory bowel disease: A 13-year nationwide cohort study in an Asian population. Am J Surg. 2015;210(1):80-6. https://doi.org/10.1016/j.amjsurg.2014.08.026 PMid:25457233 DOI: https://doi.org/10.1016/j.amjsurg.2014.08.026

Vokurka J, Olejnik J, Jedlicka V, Vesely M, Ciernik J, Paseka T. Acute mesenteric ischemia. Hepatogastroenterology. 2008;55:1349-52.

Atayan AA, Kandaurov AE, Kosenkov AN, Khachatryan EO, Belykh EN, Kirsanova EV, et al. Cardiac arrhythmia as a risk factor for acute mesenteric ischemia. Bull Dagestan State Med Acad. 2019;1:47-52.

Aouini F, Bouhaffa A, Baazaoui J, Khelifi S, Houas N, Cherif A. Acute mesenteric ischemia: Study of predictive factors of mortality. Tunis Med. 2012;90:533-6. PMid:22811227

Dewitte A, Biais M, Coquin J, Fleureau C, Cassinotto C, Ouattara A, et al. Diagnosis and management of acute mesenteric ischemia. Ann Fr Anesth Reanim. 2011;30:410-20. DOI: https://doi.org/10.1016/j.annfar.2011.02.013

Skorinova KD, Kuzmenko VV, Vasilenko IA. The prospect of creating medicines based on selenium nanoparticles (Review). Drug Dev Registr. 2020;9(2):33-44. https://doi.org/10.33380/2305-2066-2020-9-2-33-44 DOI: https://doi.org/10.33380/2305-2066-2020-9-2-33-44

Brandt LJ, Boley SJ. AGA technical review on intestinal ischemia. American gastrointestinal association. Gastroenterology. 2000;118(5):954-68. https://doi.org/10.1016/s0016-5085(00)70183-1 PMid:10784596 DOI: https://doi.org/10.1016/S0016-5085(00)70183-1

Oliva IB, Davarpanah AH, Rybicki FJ, Desjardins B, Flamm SD, Francois CJ, et al. ACR appropriateness criteria® imaging of mesenteric ischemia. Abdom Imag. 2013;38:714-9. https://doi.org/10.1007/s00261-012-9975-2 DOI: https://doi.org/10.1007/s00261-012-9975-2

Yikilmaz A, Karahan OI, Senol S, Tuna IS, Akyildiz HY. Value of multislice computed tomography in the diagnosis of acute mesenteric ischemia. Eur J Radiol. 2011;80(2):297-302. https://doi.org/10.1016/j.ejrad.2010.07.016 PMid:20719444 DOI: https://doi.org/10.1016/j.ejrad.2010.07.016

Maksimenko MB, Tylocin IO, Petrus VG. Standard for the diagnosis of acute intestinal vascular insufficiency in a multidisciplinary clinic. Eur Res. 2017;2:97-101.

Komarov TN, Shohin IE, Miskiv OA, Bogdanova DS, Aleshina AV, Medvedev YV, et al. Development and validation of atazanavir and ritonavir determination in human plasma by HPLC-MS method. Drug Dev Registr. 2020;9(1):99-108. https://doi.org/10.33380/2305-2066-2020-9-1-99-108 DOI: https://doi.org/10.33380/2305-2066-2020-9-1-99-108

Neroyev VV, Saakian SV, Miakoshina EB, Iurovskaia NN, Riabina MV, Zaĭtseva OV, et al. Differential diagnosis of early central choroidal melanoma and late stage age-related macula degeneration. Vestnik Oftalmol. 2013;129(1):39-45. PMid:23650747

Aboyans V, Ricco JB, Bartelink ML, Bjorck M, Brodmann M, Cohnert T, et al. 2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European society for vascular surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries endorsed by: The European stroke organization (ESO) the task force for the diagnosis and treatment of peripheral arterial diseases of the European society of cardiology (ESC) and of the European society for vascular surgery (ESVS). Eur Heart J. 2018;39:763-816. https://doi.org/10.15829/1560-4071-2018-8-164-221 PMid:28886620 DOI: https://doi.org/10.15829/1560-4071-2018-8-164-221

Bala M, Kashuk J, Moore EE, Kluger Y, Biffl W, Gomes CA, et al. Acute mesenteric ischemia: Guidelines of the world society of emergency surgery. World J Emerg Surg. 2017;12:1-14. https://doi.org/10.1186/s13017-017-0150-5 PMid:28794797 DOI: https://doi.org/10.1186/s13017-017-0150-5

Trineeva OV, Gudkova AA, Rudaya MA. Application of luminescent microscopy in analysis of anatomic-diagnostic signs of fruits of sea buckthorn. Drug Dev Registr. 2020;9(1):40-5. https://doi.org/10.33380/2305-2066-2020-9-1-40-45 DOI: https://doi.org/10.33380/2305-2066-2020-9-1-40-45

Wong PF, Gilliam AD, Kumar S, Shenfine J, O’Dair GN, Leaper DJ. Antibiotic regimens for secondary peritonitis of gastrointestinal origin in adults. Cochrane Database Syst Rev. 2005;2:CD004539. https://doi.org/10.1002/14651858.cd004539.pub2 PMid:15846719 DOI: https://doi.org/10.1002/14651858.CD004539.pub2

Yanar F, Ağcaoğlu O, Gök AF, Sarici IS, Ozcinar B, Aksakal N, et al. The management of mesenteric vein thrombosis: A single institution’s experience. Ulus Travma Acil Cerrahi Derg. 2013;19(3):223-8. https://doi.org/10.5505/tjtes.2013.47542 PMid:23720109 DOI: https://doi.org/10.5505/tjtes.2013.47542

Becquemin JP. Management of the diseases of mesenteric arteries and veins: clinical practice guidelines of the European society for vascular surgery (ESVS). Eur J Vasc Endovasc Surg. 2017;53(4):455-7. https://doi.org/10.1016/j.ejvs.2018.09.006 PMid:28359439 DOI: https://doi.org/10.1016/j.ejvs.2018.09.006

Jia Z, Jiang G, Tian F, Zhao J, Li S. Wang K, et al. Early endovascular treatment of superior mesenteric occlusion secondary to thromboemboli. Eur J Vasc Endovasc Surg. 2014;47(2):196-203. https://doi.org/10.1016/j.ejvs.2013.09.025 PMid:24183620 DOI: https://doi.org/10.1016/j.ejvs.2013.09.025

Kim BG, Ohm JY, Bae MN, Kim HN, Kim YJ, Chung MH, et al. Successful percutaneous aspiration thrombectomy for acute mesenteric ischemia in a patient with atrial fibrillation despite optimal anticoagulation therapy. Can J Cardiol. 2013;29(10):1329-36. https://doi.org/10.1016/j.cjca.2012.12.008 PMid:23465342 DOI: https://doi.org/10.1016/j.cjca.2012.12.008

Simó G, Echenagusia AJ, Camúñez F, Turégano F, Cabrera A, Urbano J. Superior mesenteric arterial embolism: Local fibrinolytic treatment with urokinase. Radiology. 1997;204(3):775-9. https://doi.org/10.1148/radiology.204.3.9280258 PMid:9280258 DOI: https://doi.org/10.1148/radiology.204.3.9280258

Acosta S, Björck M. Modern treatment of acute mesenteric ischaemia. Br J Surg. 2014;101(1):100-8. PMid:24254428 DOI: https://doi.org/10.1002/bjs.9330

Sreedharan S, Tan YM, Tan SG, Soo KC, Wong WK. Clinical spectrum and surgical management of acute mesenteric ischaemia in Singapore. Singapore Med J. 2007;48(4):319-23. PMid:17384879

Kougias P, Lau D, El Sayed HF, Zhou W, Huynh TT, Lin PH. Determinants of mortality and treatment outcome following surgical interventions for acute mesenteric ischemia. J Vasc Surg. 2007;46(3):467-74. https://doi.org/10.1016/j.jvs.2007.04.045 PMid:17681712 DOI: https://doi.org/10.1016/j.jvs.2007.04.045

Edwards MS, Cherr GS, Craven TE, Olsen AW, Plonk GW, Geary RL, et al. Acute occlusive mesenteric ischemia: Surgical management and outcomes. Ann Vasc Surg. 2003;17(1):72-9. https://doi.org/10.1007/s10016-001-0329-8 PMid:12522695 DOI: https://doi.org/10.1007/s10016-001-0329-8

Wadman M, Syk I, Elmståhl S. Survival after operations for ischaemic bowel disease. Eur J Surg. 2000;166(11):872-7. PMid:11097154 DOI: https://doi.org/10.1080/110241500447263

Lobo Martínez E, Meroño Carvajosa E, Sacco O, Molina EM. Embolectomy in mesenteric ischemia. Rev Esp Enferm Dig. 1993;83(5):351-4. PMid:8318278

Eltarawy IG, Etman YM, Zenati M, Simmons RL, Rosengart MR. Acute mesenteric ischemia: The importance of early surgical consultation. Am Surg. 2009;75(3):212-9. https://doi.org/10.1177/000313480907500305 PMid:19350855 DOI: https://doi.org/10.1177/000313480907500305

Aliosmanoglu I, Gul M, Kapan M, Arikanoglu Z, Taskesen F, Basol O, et al. Risk factors effecting mortality in acute mesenteric ischemia and mortality rates: A single center experience. Int Surg. 2013;98(1):76-81. https://doi.org/10.9738/cc112.1 PMid:23438281 DOI: https://doi.org/10.9738/CC112.1