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Symptomatic Mesenteric Atherosclerotic Disease-Lessons Learned from the Diagnostic Workup.

Björnsson, Steinarr LU ; Resch, Timothy and Acosta, Stefan LU orcid (2013) In Journal of Gastrointestinal Surgery 17(5). p.973-980
Abstract
OBJECTIVE: This study aims to analyze the diagnostic workup in patients referred for endovascular mesenteric revascularization for symptomatic mesenteric atherosclerotic disease. MATERIAL AND METHODS: Fifty-five patients were identified between 2006 and 2011. Median follow-up time was 24 months. RESULTS: Median age was 71 years, 67 % were women. Forty patients had acute on chronic mesenteric ischemia, eight had acute mesenteric ischemia, and seven had chronic mesenteric ischemia. Other manifestations of atherosclerotic disease were present in 71 %. Body mass index (BMI) <20 kg/m(2) was found in 37 %. Endoscopy diagnosed duodenitis (38 %; 13/34) and colitis in the right colon (57 %;12/21). All ulcers tested for Helicobacter pylori were... (More)
OBJECTIVE: This study aims to analyze the diagnostic workup in patients referred for endovascular mesenteric revascularization for symptomatic mesenteric atherosclerotic disease. MATERIAL AND METHODS: Fifty-five patients were identified between 2006 and 2011. Median follow-up time was 24 months. RESULTS: Median age was 71 years, 67 % were women. Forty patients had acute on chronic mesenteric ischemia, eight had acute mesenteric ischemia, and seven had chronic mesenteric ischemia. Other manifestations of atherosclerotic disease were present in 71 %. Body mass index (BMI) <20 kg/m(2) was found in 37 %. Endoscopy diagnosed duodenitis (38 %; 13/34) and colitis in the right colon (57 %;12/21). All ulcers tested for Helicobacter pylori were negative (n = 17). Patients received proton pump inhibitor, antibiotic, and cortisone therapy during diagnostic workup in 73, 42, and 29 % of the cases, respectively. Previous hospitalization for the same complaints had occurred in 78 %. CT angiography showed occlusion (n = 30) and high-grade stenosis (n = 25) of the superior mesenteric artery (SMA). Forty-eight patients were treated with stenting of the SMA. The BMI increased in both women (p = 0.001) and men (p = 0.03) after endovascular therapy. The in-hospital mortality rate was 18 %. CONCLUSION: Patients with abdominal pain, known atherosclerotic disease, right-sided colitis or H. pylori-negative duodenitis should undergo CT angiography immediately to be able to identify symptomatic mesenteric atherosclerotic disease. (Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Gastrointestinal Surgery
volume
17
issue
5
pages
973 - 980
publisher
Springer
external identifiers
  • wos:000317862200017
  • pmid:23307340
  • scopus:84876148164
ISSN
1873-4626
DOI
10.1007/s11605-013-2139-z
language
English
LU publication?
yes
id
4119f968-207b-4dd2-b4f3-836fdba56578 (old id 3438850)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23307340?dopt=Abstract
date added to LUP
2016-04-01 10:58:56
date last changed
2022-01-26 04:25:47
@article{4119f968-207b-4dd2-b4f3-836fdba56578,
  abstract     = {{OBJECTIVE: This study aims to analyze the diagnostic workup in patients referred for endovascular mesenteric revascularization for symptomatic mesenteric atherosclerotic disease. MATERIAL AND METHODS: Fifty-five patients were identified between 2006 and 2011. Median follow-up time was 24 months. RESULTS: Median age was 71 years, 67 % were women. Forty patients had acute on chronic mesenteric ischemia, eight had acute mesenteric ischemia, and seven had chronic mesenteric ischemia. Other manifestations of atherosclerotic disease were present in 71 %. Body mass index (BMI) &lt;20 kg/m(2) was found in 37 %. Endoscopy diagnosed duodenitis (38 %; 13/34) and colitis in the right colon (57 %;12/21). All ulcers tested for Helicobacter pylori were negative (n = 17). Patients received proton pump inhibitor, antibiotic, and cortisone therapy during diagnostic workup in 73, 42, and 29 % of the cases, respectively. Previous hospitalization for the same complaints had occurred in 78 %. CT angiography showed occlusion (n = 30) and high-grade stenosis (n = 25) of the superior mesenteric artery (SMA). Forty-eight patients were treated with stenting of the SMA. The BMI increased in both women (p = 0.001) and men (p = 0.03) after endovascular therapy. The in-hospital mortality rate was 18 %. CONCLUSION: Patients with abdominal pain, known atherosclerotic disease, right-sided colitis or H. pylori-negative duodenitis should undergo CT angiography immediately to be able to identify symptomatic mesenteric atherosclerotic disease.}},
  author       = {{Björnsson, Steinarr and Resch, Timothy and Acosta, Stefan}},
  issn         = {{1873-4626}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{973--980}},
  publisher    = {{Springer}},
  series       = {{Journal of Gastrointestinal Surgery}},
  title        = {{Symptomatic Mesenteric Atherosclerotic Disease-Lessons Learned from the Diagnostic Workup.}},
  url          = {{http://dx.doi.org/10.1007/s11605-013-2139-z}},
  doi          = {{10.1007/s11605-013-2139-z}},
  volume       = {{17}},
  year         = {{2013}},
}