Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy

被引:233
作者
Trompeter, M
Brazda, T
Remy, CT
Vestring, T
Reimer, P
机构
[1] Univ Freiburg, Acad Teaching Hosp, Stadt Klinikum Karlsruhe, Dept Radiol, D-76133 Karlsruhe, Germany
[2] Univ Gottingen, Acad Teaching Hosp, Diakonie Krankenhaus Rotenburg Wumme, Dept Radiol, D-27342 Rotenburg Wumme, Germany
关键词
non-occlusive mesenteric ischemia; intra-arterial DSA; CT; MRI; vasodilator therapy;
D O I
10.1007/s00330-001-1220-2
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Non-occlusive mesenteric ischemia (NOMI) compromises all forms of mesenteric ischemia with patent mesenteric arteries. It generally affects patients over 50 years of age suffering from myocardial infarction, congestive heart failure, aortic insufficiency, renal or hepatic disease and patients following cardiac surgery. Non-occlusive disease accounts for 20-30% of all cases of acute mesenteric ischemia with a mortality rate of the order of 50%. Acute abdominal pain may be the only early presenting symptom of mesenteric ischemia. Non-invasive imaging modalities, such as CT, MRI, and ultrasound, are able to evaluate the aorta and the origins of splanchnic arteries. Despite the technical evolution of those methods, selective angiography of mesenteric arteries is still the gold standard in diagnosing peripheral splanchnic vessel disease. In early non-occlusive mesenteric ischemia, as opposed to occlusive disease, there is no surgical therapy. It is known that mesenteric vasospasm persists even after correction of the precipitating event. Vasospasm frequently responds to direct intra-arterial vasodilator therapy, which is the only treatment that has been shown to be effective.
引用
收藏
页码:1179 / 1187
页数:9
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