Article: article from journal or magazin.
Case report (case report): feedback on an observation with a short commentary.
A case of acute mesenteric ischemia that responded to a combined treatment concept.
Publication types: Case Reports ; Journal Article - Publication Status: ppublish
Acute mesenteric ischemia (AMI) is still associated with a high mortality rate. Early diagnosis and treatment are mandatory since irreversible bowel damage occurs within a few hours of total ischemia. Reactive vasoconstriction, high postoperative vascular reocclusion rate and the release of toxic substances from the damaged bowel followed by bacterial translocation are all part of the disease process. A combined treatment plan for AMI devides to combat the unrelenting disease process on different levels involving early operation, perioperative intraarterial fibrinolytic and vasodilative treatment and anticoagulation, selective small bowel decontamination and mandatory second look operation is presented. The rationale of this concept and its successful outcome in a highly complex case are discussed.
Adult, Anti-Bacterial Agents, Bacterial Translocation, Clinical Protocols, Drug Therapy, Combination/therapeutic use, Embolectomy, Embolism/surgery, Embolism/therapy, Fibrinolysis, Heparin/therapeutic use, Humans, Ileum/blood supply, Ileum/surgery, Ischemia, Male, Mesenteric Artery, Superior, Mesenteric Vascular Occlusion/surgery, Mesenteric Vascular Occlusion/therapy, Recurrence, Reoperation, Sepsis/microbiology
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