A simple but useful method of screening for mesenteric ischemia secondary to acute aortic dissection
| Autor: | Kanshi Komatsu, Yasufumi Asai, Nobuyoshi Kawaharada, Naoya Yama, Johji Fukada, Kiyofumi Morishita, Tomio Abe, Yoshihiko Kurimoto |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Ischemia chemistry.chemical_compound Mesenteric Veins Mesenteric Artery Superior Internal medicine medicine.artery Lactate dehydrogenase medicine Humans Mass Screening Body Weights and Measures Mesentery Lactic Acid Superior mesenteric artery Superior mesenteric vein Aged Retrospective Studies Aortic dissection Vascular disease business.industry Middle Aged medicine.disease Aortic Aneurysm Surgery Aortic Dissection medicine.anatomical_structure chemistry Mesenteric ischemia Cardiology Female Tomography X-Ray Computed business |
| Zdroj: | Surgery. 136:42-46 |
| ISSN: | 0039-6060 |
| DOI: | 10.1016/j.surg.2003.12.019 |
| Popis: | Background In spite of recent improvements in treatment for acute aortic dissection, mesenteric ischemia secondary to aortic dissection is still challenging. We propose a simple screening method to detect mesenteric ischemia secondary to acute aortic dissection. Methods From 1991 to 2002, 245 patients with acute aortic dissection were admitted to our hospital. Nine (3.7%) of those were complicated with mesenteric ischemia. The clinical records of those 9 patients were retrospectively analyzed. The ratios of the diameter of the superior mesenteric vein (SMV) to that of the superior mesenteric artery (SMA) were calculated in patients with mesenteric ischemia (group M) and in patients without mesenteric ischemia (group C). Blood test data, including results of arterial blood gas analysis, in the 2 groups were also compared. Results The SMV/SMA ratios in groups M and C were 1.16 ± 0.33 and 1.78 ± 0.29, respectively ( P = .003). A cutoff value of the SMV/SMA ratio was 1.5 (sensitivity, 88.9%; specificity, 88.9%) with an odds ratio of 64.0. Although there were differences between the 2 groups in glutamate oxaloacetate transaminase, lactate dehydrogenase, creatine phosphate kinase, pH, and lactate values, the measurement of lactate was especially useful ( P = .002). Conclusions The combination of the SMV/SMA ratio and lactate concentration is a useful screening method to detect mesenteric ischemia secondary to acute aortic dissection. |
| Databáze: | OpenAIRE |
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