Isquemia mesentérica

Mesenteric ischemia

Debido a la alta incidencia y graves consecuencias que produce, la isquemia mesentérica representa un reto para el terapeuta que la enfrenta. Las consecuencias fisiopatológicas que comprometen muy rápido todo el sistema orgánico, hacen de su diagnóstico precoz no sólo un reto sino la clave del éxito en su manejo. Esta revisión pretende describir en detalle las características de la circulación esplácnica y así mismo revisa las principales estrategias diagnósticas y su manejo.

1. GastrointestinalDisease andDysfunction In: Gabrielli A, Layon AJ, Yu M, editors. Civetta, Taylor and Kirby's: Critica! care. 4th ed. Philadelphia : 2009 Lippincott Williams and Wilk:ins; 2008. p. 2368-78.
2. Mamode N, Pickford I, Leiberman P. Failure to improve outcome in acule mesentericischaemia: seven-year review. Eur J Surg. I999; 165(3): 203-8.
3. Brand! LJ, Boley SJ. AGA technical review on intestinal ischemia. Gastroenterology 2000;118(5): 954-68.
4. HerbertGS, Steele SR. Acute and chronic mesenteric ischemia. Surg Clin North Am. 2007; 87(5):1115-34.
5. Ozden N, Gurses B. Mesenteric ischemia in the elderly. Clin Geriatr Med. 2007; 23(4): 871-87.
6. Bartone G, Severino BU, Armellino MT, et al. Clinical symptoms of intes­ tinal vascular disorders. Radio] Clin North Am. 2008; 46: 887-9.
7. Lobo Martinez E, Carvajosa E, Sacco O, et al. Embolectomy in mesenteric ischemia. Rev Esp EnfermDig. 1993; 83:351-4.
8. Lyon C, ClarkDC.Diagnosis of acule abdominal pain in older patients. Am Fam Physician. 2006; 74:1537-44.
9. Acosta S, Ogren M, Sternby NH, et al. Clinical implications for the management of acute thromboemolic occlusion of thesuperior mesenteric artery. Ann Surg. 2005; 241(3):516-22.
10. Burns BJ, Brandt LJ. Intestinal ischernia. Gastroenterol Clin North Am. 2003; 32(4):1127-43.
11. Acosta S, Ogren M, Stemby NH, et al. Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors. J Intern Med. 2006; 259: 305-13.
12. Clark ET, GewerzBL. Intermittent ischemia potentiates intestinal reperfusion injury. J. Vasc. Surg. 1991; 13: 606-61.
13. Martinez JP, Hogan GJ. Mesenteric ischemia. Emerg Med Clin North Am. 2004;22 (4):909-28.
14. Pique JM. Management of gut ischemia. Indian J Gastroenterol. 2006; 25(Suppl): S39-42.
15. Berland T, Oldenburg WA. Acute mesenteric ischemia. Curr Gastroenterol Rep. 2008; 10: 341-6.
16. Painés J, Soriano A. Isquemia mesentérica aguda. Fisiopatología y diagnos­ tico. GH continuada. 2002; 1(3): 103-109.
17. Romano S, Niola R, Maglione F, et al. Small bowelvasculardisordersfrom arterial etiology and impaired venous drainage. Radio! Clin North Am. 2008;46:891 908.
18. Horton KM, Fishman EK. Multidetector CT angiography in the diagnosis of mesenteric ischemia. Radio! Clin North Am. 2007;45: 275-88.
19. Kolkman JJ, Bargeman M, Huisman AB, Geelkerken RH. Diagnosis and management of splanchnic ischemia. World J Gastroenterol. 2008 Dec 28;14(48):7309-20.
20. De Backer D, Creteur J, Silva E, Vincent JL. Effects of dopamine, norepinephrine, and epinephrine on the splanchnic circulation in septic shock: Which is best?. Crit Care Med. 2003 Jun; 31(6):1659-67.
21. Oldenburg WA, Lau LL, Rodenberg TJ, et al. Acule mesentericischemia: a clinical review.Arch lntem Med. 2004; 164:1054---62.
22. Kozuch PL,Brandt LJ.Reviewarticle: diagnosis and management of mesemeric ischaemia with an emphasis on pharmacotherapy.Aliment Pharmacol Ther 2005; 21(3): 201-15.
23. Frishman WH, Novak S, Brandt U, et al.Pharmacologic management of mesenteric occlusive disease. Cardiol Rev. 2008; 16:59-68.
24. Shoots IG, Levi NM, Reekers JA, et al. Thrombolytic therapy for acute superiormesentericartery occlusion.J Vasc Interv Radio!. 2005;16: 317-29.
25. Wain RA, Hines G.Surgical management of mesenteric occlusive disease: a contemporary review of invasive and minirnally invasive techniques. Cardiol Rev.2008;16: 69 75.
26. Kougias P, Lau D, El Sayed H, et al. Detenninants of mortality and treatment outcome following surgical interventions for acute mesenteric ischemia. J Vasc Surg.2007; 46: 467 74.
27. Acosta-Merida MA, Marchena-Gomez J, Hemmersbach-Miller M, et al. ldentification of risk factors for perioperative mortality in acute mesenteric ischemia. World J Surg. 2006; 30(8): 1579-85.
28. Schoots IG, Koffeman GI, Legemate DA, et al.Systematic review of survival after acule mesenteric ischaemia according to disease aetiology. Br J Surg. 2004; 91(1):17 27.
29. Bradbury AW, Brittenden J, McBride K, et al. Mesenteric ischaemia: a multidisciplinary approach. Br J Surg. 1995; 82(11):1446-59.
30. Schoots IG, Levi MM, Reekers JA, et al. Thrombolytic therapy for acute superior mesentericartery occlusion. J Vasc Interv Radio!. 2005; 16(3):317-29.
31. Sreenarashimhaiah J. Chronic mesenteric ischemia. Best Pract Res Clin Gastroenterol.2005;19(2):283-95.
32. Wilson DB, Mostafavi K, Craven TE, et al. Clinical course of mesenteric artery stenosisin elderly Americans. Arch lntem Med. 2006; 166:2095-100.
33. Hansen KJ, Wilson DB, Craven TE, et al. Mesenteric artery disease in the elderly. J Vasc Surg.2004; 40:45 52.
34. Meaney JF, Prince MR, Nostrant TT, et al. Gadolinium - enhanced MR angiography of visceral arteries in patients with suspected chronic mesenteric ischemia. J Magn Reson Imaging. 1997; !:171-6.
35. Wain RA,Hines G. Surgical management of mesenteric occlusive disease: a contemporaryreview of invasive and minirnally invasive techniques. Cardiol Rev. 2008; 16 :69 75.
36. Atkins MD, Kwolek CJ, LaMuraglia GM, et al. Surgical revascularization versus endovascular therapy for chronic mesentericiscbemia:a comparative experience. J Vasc Surg. 2007; 45:1162-7.
37. Sullivan TM, Oderich GS, Malgor RD, Ricotta II JJ. Revascularizacion abierta y endovascular para la isquemiamesentericacronica:revisióntabula­ da de los estudios publicados. An. cir. vasc. 2009; 23(5): 770-82.
38. Levy AD. Mesenteric ischemia.Radio! Clin NorthAm. 2007; 45:593-9
39. Balthazar EJ, Liebeskind ME, Macari M. Intestinal ischemia in patients in whom small bowel obstruction is suspected: evaluation of accuracy, limitations, and clinical implications of CT in diagnosis. Radiology. 1997; 205(2):519 22.
40. Frager D, Baer JW, Medwid SW, et al. Detection of intestinal ischemia in patients with acute small-bowel obstruction due to adhesions or hernia: efficacy of CT.AJR Am JRoentgenol.1996;166(1): 67-7l.
41. Cademartiri F, Raaijmakers RH, Kuiper JW, et al. Multi- detector row CT angiography in patients witb abdominal angina. Radiographics. 2004; 24(4):969-84.
42. Marchena-Gomez J, Acosta-Merida MA, Hemrnersbach-Miller M, et al. El índice de comorbilidad de Charlson ajustado por edad como variable pronos­ tica en pacientes con isquemia mesentérica aguda.An. cir.vasc. 2009; 23(4): 505-12.
43. Acosta-Mérida MA et al.Factores predictivos de necrosis masiva intestinal en la isquemia mesentérica. Cir Esp. 2007; 81(3):144-9.
44. Stoney RJ, Cunningham CG. Acute mesenteric ischemia. Surgery. 1993; 114:489-90.
45. Horton KM, Fishman EK.Multidetector CT angiographyin the diagnosis of mesentericischemia. Radio! Clin North Am. 2007 Mar;45(2):275-88.
46. Rootbottom CA, Dubbins PA. Significant disease of the ce!iac and superior mesenteric arteries in asymptomatic patients: predictive value of Doppler sonography.AJRAmJ Roentgenol.1993; 161(5):985-8.
47. Thomas IB, Blake K, Pierce GE, et al.The clínica! course of asymptomatic mesenteric arterial stenosis. J Vasc Surg. 1998; 27(5):840-4.
48. Carvajal Balaguera J, et al. Neumatosis intestinal y gas en el territorio venoso portomesentérico en el paciente anciano: etiología, fisiopatología y significado clínico. Rev Esp Geriatr Gerontol. 2007; 42(6):364-9.
49. Peloponissios N, Halkic N, Pugna!e M, Jomod P, Nordback P, Meyer A. Hepatic portal gas in adults. Review of the literature and presentation of consecutive series of 11cases.Arch Surg. 2003; 138:1367-70.
50. De Brawer J, Masereel B, Visser R, Geyskens P. Pneumatosis intestinalis by ischaemic bowel: report of three cases. Acta Chir Belg.2006; 106:592-5.
51. Schindera S, Triller J, VockP, HoppeH. Detection of hepatic venous gas: its clínica! and outcome.Emerg Radio!.2006; 12: 164-70.