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- 1. Akut Mezenter İskemi Dr Hakan Yanar İstanbul Üniversitesi İstanbul Tıp Fakültesi Genel Cerrahi Anabilim Dalı 16 Nisan 2009
- 6. J Vasc Surg 2002;35:445-52
- 15. Risk Fa ktörleri J Vasc Surg 2002;35:445-52
- 16. Risk Fa ktörleri Ann Surg 2001;233(6):801-808
- 17. Risk fa ktörleri Ann Surg 2001;233(6):801-808
- 20. Klinik prezentasyon Ann Vasc Surg 2003;17:72-79
- 21. Klinik prezentasyon Ann Surg 2001;233(6):801-808
- 23. BT Anjiografi: Multidete k t ö r BT akut ve kronik mezenterik iskeminin tanısında idealdir Horton KM, et al. Radiol Clin North Am. 2007 Mar;45(2):275-88. Review
- 24. BT bulguları Kirkpatrick IDC et al., Radiology 2003 Pneumatosis intestinalis 11 0 42 100 Arterial embolism 3 0 12 100 SMA or portal venous gas 3 0 12 100 Focal lack of bowel wall 11 1 42 97 enhancement Free intraperitoneal air 5 2 19 94 Mesenteric vein thrombosis 4 2 15 94 Bowel dilatation 17 6 65 83 Bowel wall thickening 22 10 85 72 CT Finding n=26 n=36 (%) (%) Patients with AMI Control Group Sensitivity Specifity
- 25. CTA: SMA Emboli
- 26. SMV Trombozu
- 37. t-PA öncesi 24 saat sonra
- 38. Cerrahi embolektomi ± rezeksiyon
- 41. ???
- 44. Laparoscopic management of A MI Minor ischemia Necrosis Complete resolution
- 45. World Journal of Gastroenterology 2007 Jun 28;13(24):3350-053.
- 48. Non viable dokuların rezeksiyonu + anastomoz / stoma
- 49. 5. Gün 7. Gün
- 50. 7. Gün Duodeno- ileostomi Transvers kolon Duodenum İleum
- 58. Çölyak trunkusa stent sonrası
- 62. Üçüncül Bakı Terminal ileum Apandiks Çekum Terminal ileum
- 69. İKİNCİL BAKI
- 71. ÜÇÜNCÜ BAKI
Notas del editor
- 150 yıl önce tanımlanmış ancak 30 gün mortalite günümüzde %32-60 arasında. Bu oran sadece gecikmiş tanı ve eşlik eden hastalıklardan değil barsak iskemisinin lokal ve sistemik etkilerinden kaynaklanır. Barsaklar low flow sonrası metabolik, hormaonal ve vazoaktif düzenleyici görevlerini yerine getiremez.
- Why worry about it? TPN dependence 30% Early diagnosis improved these rates and hallmark of care of these patients Incidence likely to increase with care of older population Underestimation: subclinical disease Mortality high because diagnosis made after infarciton, gut damage proceeds even after revascularization, concomitant medcal problems and poor distal mesenteric circulation
- Can become irreversible even after cause reversed (esp in presence of atherosclerotic disease). Often stenotitc arteries present (acute on chronic disease)
- Limited clinical utility due to low sensitivity, low specificity, and markers only appear after gut infarction.
- pneumatosis venous gas SMA/celiac/IMA occlusion w/distal disease arterial embolism OR bowel wall thickening + one of following: lack of bowel wall enhancement solid organ infarction venous thrombosis
- In 1996 the U.S. Food and Drug Administration (FDA) approved the use of tPA to treat ischemic stroke in the first three hours after the start of symptoms.
- Kontrol angiografi: SMA’ da %70 rekanalizasyon, proksimal jejunal ve ileokolik dalların açıldığı görüldü
- Department of Surgery, School of Medicine, Gazi University, Ankara