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Related Experiment Video

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Gastro-intestinal vascular emergencies.

Olivier Corcos1, Alexandre Nuzzo

  • 1Department of Gastroenterology, IBD, Nutritional Support and Intestinal Transplantation, Beaujon Hospital Clichy, Paris VII University, 100 Boulevard du General Leclerc, 92110 Clichy, France.

Best Practice & Research. Clinical Gastroenterology
|October 29, 2013
PubMed
Summary
This summary is machine-generated.

Gastro-intestinal vascular emergencies, or digestive ischaemic injuries, require prompt diagnosis for better outcomes. Early recognition and a multidisciplinary approach can prevent severe complications like intestinal infarction and death.

Keywords:
Acute mesenteric ischaemiaIntestinal failureIntestinal ischaemic injuryIntestinal strokeIschaemic colitisNon-occlusiveRevascularizationShort bowel syndromeSuperior mesentery arteryTranslocation

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Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Emergency Medicine

Background:

  • Gastro-intestinal vascular emergencies encompass digestive ischaemic injuries from vascular or haemodynamic issues.
  • These injuries, ranging from occlusive to non-occlusive and arterial to venous, pose risks of infarction, organ failure, and mortality.
  • Diagnosis is challenging due to often unknown risk factors and lack of biomarkers, necessitating suspicion based on sudden, severe abdominal pain despite normal physical exams.

Purpose of the Study:

  • To outline a multimodal and multidisciplinary management strategy for gastro-intestinal vascular emergencies.
  • To emphasize early diagnosis and intervention to improve patient outcomes.
  • To reduce the need for extensive intestinal resections and prevent mortality.

Main Methods:

  • Diagnosis relies on clinical suspicion of acute mesenteric ischaemia, confirmed by abdominal computed tomography angiography.
  • The angiography identifies intestinal ischaemic injury, including vascular occlusion or low flow states.
  • Management is guided by a strategy based on gastro-intestinal viability and a defined algorithm.

Main Results:

  • A multimodal and multidisciplinary approach has been developed based on recent pathophysiological insights and clinical experience.
  • The strategy aims to guide management decisions effectively.
  • The primary goals are to minimize surgical intervention and improve survival rates.

Conclusions:

  • Prompt diagnosis of gastro-intestinal vascular emergencies is crucial, often indicated by unusual abdominal pain.
  • Abdominal computed tomography angiography is key for confirming intestinal ischaemic injury.
  • A coordinated, multidisciplinary management strategy can significantly reduce intestinal resections and mortality.