Nonoсclusive mesenteric ischemia (literature review)
DOI:
https://doi.org/10.15574/PS.2021.72.76Keywords:
acute mesenteric ischemia, non-occlusive disorders of mesenteric blood flowAbstract
Non-occlusive mesenteric ischemia is a relatively rare but extremely complex pathology in terms of diagnosis. A wide range of reasons for the development of non-occlusive impression dramatically complicates the diagnosis and differentiation with other abdominal pathology. The vast majority of publications in the domestic literature on acute disorders of mesenteric blood flow, mostly address the problems of diagnosis and treatment of occlusive types of mesenteric ischemia, while the topic of non-occlusive ischemia remains insufficiently covered.
Given that in half of the cases NOMI is diagnosed at the stage of irreversible necrotic changes of the intestine – there is a real need to generalize the root causes and mechanisms of neoclustive mesenteric ischemia, modern methods of diagnosis and treatment.
Purpose – to analyze of the causes, prevalence, classification, diagnosis and treatment of non-occlusive disorders of mesenteric blood flow.
This research, based on literature review, showed that acute non-occlusive mesenteric ischemia (NOMI) is associated with poor prognosis due to the lack of accurate diagnostic measures. First of all, clarity regarding biochemical markers. Therefore, the research and development of the latter is seen as a priority. Contrast methods of examination (computed tomography, angiography) are the only possible diagnostic tools. Pharmacological correction is fundamental and presupposes the use of drugs with a vasodilating effect systemically or locally (catheter-associated). An important issue is the development of pharmacological agents that allow targeted action on the pathogenetic mechanisms of the development of NOMI. A multidisciplinary approach involving a specialized doctor, a surgeon, an X-ray endovascular surgeon and an intensive care physician in the treatment of a patient with suspected NOMI is the foundation for the success of therapy. The question of the use of laparoscopy remains controversial, given the invasiveness of the method and the difficulty of interpreting the changes detected in the early phase of the disease.
No conflict of interests was declared by the authors.
References
Arakelyan VS, Barbarash OL, Bolotova EV, Karpenko AA, Kozyirev OA, Samorodskaya IV, Troitskiy AV. (2010). Natsyonalnіe rekomendatsyy po vedenyiu patsyentov s sosudystoi arteryalnoi patolohyei (Rossyiskyi Sohlasytelnіi dokument). Moskva: 208-210.
Archodovassilis F. (2007). Nonocclusive mesenteric ischemia: a lethal cjmplication in peritoneal dialysis patients. Perit Dial Int. 27: 136-141. https://doi.org/10.1177/089686080702700206; PMid:17299146
Auxiliadora-Martins M. (2010). Fulminant Nonocclusive Mesenteric Ischemia Just after Hip Arthroplasty. Case Reports in Medicine: 4. https://doi.org/10.1155/2010/250436; PMid:20300426 PMCid:PMC2840376
Bala M, Kashuk J, Moore EE, Kluger Y, Biffl W, Gomes CA, Ben-Ishay O, Rubinstein C, Balogh ZJ, Civil I, Coccolini F, Leppaniemi A, Peitzman A, Ansaloni L, Sugrue M, Sartelli M, Di Saverio S, Fraga GP, Catena F. (2017). Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 12: 38. https://doi.org/10.1186/s13017-017-0150-5; PMid:28794797 PMCid:PMC5545843
Bawany MZ. (2010). The Unusual Suspect: A Case of Non-occlusive Mesenteric Ischemia in a Patient With Cirrhosis. Gastroenterology Research. 3 (5): 232-233. https://doi.org/10.4021/gr226w; PMid:27957004 PMCid:PMC5139723
Bourcier S, Klug J, Nguyen LS. (2021). Non-occlusive mesenteric ischemia: Diagnostic challenges and perspectives in the era of artificial intelligence. World journal of gastroenterology. 27 (26): 4088-4103. https://doi.org/10.3748/wjg.v27.i26.4088; PMid:34326613 PMCid:PMC8311528
Chehab BM. (2008). Non-Occlusive Mesenteric Ischemia. Kansas Journal of Medicine: 49-52. https://doi.org/10.17161/kjm.v1i3.11269
Cocorullo G, Mirabella A, Falco N, Fontana T, Tutino R, Licari L, Salamone G, Scerrino G, Gulotta G. (2017). An investigation of bedside laparoscopy in the ICU for cases of non-occlusive mesenteric ischemia. World J Emerg Surg. 18 (12): 4. https://doi.org/10.1186/s13017-017-0118-5; PMid:28115983 PMCid:PMC5241960
Dhoble A. (2008). Non-occlusive mesenteric ischemia leading to 'pneumatosis intestinalis': a series unfortunate hemodynamic events. Cases Journal. 1: 60. https://doi.org/10.1186/1757-1626-1-60; PMid:18657272 PMCid:PMC2499993
Han SY et al. (2000). Nonocclusive Mesenteric Ischemia in a Patient on Maintenance Hemodialysis. The Korean Journal of Internal Medicine. 15 (1): 81-84. https://doi.org/10.3904/kjim.2000.15.1.81; PMid:10714097 PMCid:PMC4531750
Hroma VH. (2011). Mistse ta rol neokliuzyvnoi mezenterialnoi ishemii v strukturi hostrykh porushen krovotoku v baseinakh bryzhovykh sudyn. Eksperymentalna i klinichna medytsyna. 4 (53): 139-142.
John A.S. (2000). Nonocclusive Mesenteric Infarction in Hemodialysis Patients. J Am Coll Surg. 190: 84-88. https://doi.org/10.1016/S1072-7515(99)00226-4
Kayahan H. (2008). A case of angiographically verified non-occlusive mesentery ischemia induced by digitalis. Turk J Gastroenterol. 19 (2): 125-128.
Klotz S. (2001). Diagnosis and Treatment of Nonocclusive Mesenteric Ischemia After Open Heart Surgery. Ann Thorac Surg. 72: 1583-1586. https://doi.org/10.1016/S0003-4975(01)03179-4
Maruyama Y. (2008). Nonocclusive Mesenteric Ischemia after Aortic Surgery in a Hemodialysis Patient. Ann Thorac Cardiovasc Surg. 14: 2.
Mitsuyoshi A. (2007, Aug). Survival in Nonocclusive Mesenteric Ischemia Early Diagnosis by Multidetector Row Computed Tomography and Early Treatment With Continuous Intravenous High-dose Prostaglandin E1. Annals of Surgery. 246: 2. https://doi.org/10.1097/01.sla.0000263157.59422.76; PMid:17667501 PMCid:PMC1933563
Oldenburg AW. (2004). Acute Mesenteric Ischemia. A Clinical Review. Arch Intern Med. 164: 1054-1062. https://doi.org/10.1001/archinte.164.10.1054; PMid:15159262
Oshikata. (2013). An adult patient with Henoch-Schцnlein purpura and non-occlusive mesenteric ischemia. BMC Research Notes. 6: 26. https://doi.org/10.1186/1756-0500-6-26; PMid:23343144 PMCid:PMC3558347
Pettei MJ. (1990). Nonocclusive Mesenteric Ischemia Associated with Propranolol Overdose. Journal of Pediatric Gastroenterology & Nutrition. 10: 544-547. https://doi.org/10.1097/00005176-199005000-00020; PMid:1972743
Powell A, Armstrong P. (2014). Plasma biomarkers for early diagnosis of acuteintestinal ischemia. Semin Vasc Surg. 27: 170-175. https://doi.org/10.1053/j.semvascsurg.2015.01.008; PMid:26073827
Savelev BC, Spyrydonov YV. (1979). Ostrіe narushenyia mezenteryalnoho krovoobrashchenyia. M: Medytsyna: 232.
Stockmann H, Roblick UJ, Kluge N. (2000). Diagnosis and therapy of non-occlusive mesenteric ischemia. Zentralbl Chir. 125: 144-151.
Sudharshana Murthy KA. (2012, Jan-Mar). Non-occlusive mesenteric ischemia and the role of cilostazol in its management. J Pharmacol Pharmacother. 3 (1): 68-70. https://doi.org/10.4103/0976-500X.92513; PMid:22368425 PMCid:PMC3284045
Takeuchі N. (2012). Non-Occlusive Mesenteric Ischemia During the Course of Heart Failure. J Clin Case Rep. 2: 15. https://doi.org/10.4172/2165-7920.1000220
Thomson ABR, Shaffer EA. (2000). First principles of gastroenterology. The Canadian Association of Gastroenterology. Ischemic Disease of the Intestine. Fifth edition: 288.
Trompeter M. (2002). Non-occlusive mesenteric ischemia: ethiology, diagnosis, and interventional therapy. Eur radiol. 12: 1179-1187. https://doi.org/10.1007/s00330-001-1220-2; PMid:11976865
Wilcox MG. (1995). Current theories of pathogenesis and treatment of nonocclusive mesenteric ischemiа. Digestive diseases and sciences. 40 (4): 709-716. https://doi.org/10.1007/BF02064966; PMid:7720458
Zeier M, Wiesel M, Rambausek M, Ritz E. (1995). Non-occlusive mesenteric infarction in dialysis patients: the importance of prevention and early intervention. Nephrol Dial Transplant. 10 (6): 771-773.
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