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World Journal of Surgery

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01-08-2018 | Original Scientific Report

Predictive Factors for Intestinal Transmural Necrosis in Patients with Acute Mesenteric Ischemia

Author: Sameh Hany Emile

Published in: World Journal of Surgery | Issue 8/2018

Abstract

Background

Acute mesenteric ischemia (AMI) is a serious and potentially fatal condition. No definite parameter can predict transmural bowel necrosis in patients with AMI to justify early surgical intervention. The current study aimed to identify the clinical, laboratory, and radiologic parameters that can successfully predict the onset of intestinal transmural necrosis in patients with AMI.

Patients and methods

Records of patients with AMI in the period of January 2013 to October 2017 were reviewed. Clinical parameters as patients’ symptoms, vital signs, and signs of peritonitis along with the results of laboratory and radiologic investigations were analyzed to identify predictive factors for intestinal transmural necrosis using binary logistic regression analysis.

Results

One hundred and one patients (70 males) with mean age of 55 years were included. Venous occlusion was the cause of AMI in 78 (77.3%) patients and arterial occlusion in 23 (22.7%) patients. Twenty-two patients completed conservative treatment successfully, whereas 79 patients required exploratory laparotomy. On laparotomy, six patients were found to have viable bowel. Overall, 28 patients had viable bowel and 73 had bowel necrosis. The significant independent predictors for transmural bowel necrosis were mesenteric arterial occlusion (OR: 26.5, p = 0.02), leukocytosis (OR: 1.3, p < 0.0001), acidosis (OR: 3.8, p = 0.04), free intraperitoneal fluid (OR: 4.21, p = 0.005), and combined portal vein and SMV thrombosis in CT scan (OR: 3.4, p = 0.026).

Conclusion

The independent predictors for transmural bowel necrosis were mesenteric arterial occlusion, leukocytosis, acidosis, free intraperitoneal fluid, and combined portal vein and SMV thrombosis in CT scan.

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Title: Predictive Factors for Intestinal Transmural Necrosis in Patients with Acute Mesenteric Ischemia
Author: Sameh Hany Emile
Publication date: 01-08-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 8/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-018-4503-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Predictive Factors for Intestinal Transmural Necrosis in Patients with Acute Mesenteric Ischemia

Abstract

Background

Patients and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusion

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