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PubMed1998

Mesenteric occlusive disease.

Using contrast-enhanced MR angiography, cine phase contrast MR imaging, and flow-independent T2 measurements, MR imaging can provide both morphologic information about the degree of stenosis of the mesenteric vessels and quantitative functional information about blood flow and blood oxygen saturation in these vessels. The combination of these techniques can potentially revolutionize the diagnosis and post-treatment assessments of both acute and chronic mesenteric occlusive disease.

Acute Disease↗

PubMedDate not supplied

[Acute non-obstructive necrotizing enterocolitis in adults].

Acute non-obstructive necrotizing enterocolitis in adults is characterized by pathological features: it is an intestinal necrosis beginning in the mucosa, without obstruction of the mesenteric vessels. The disease occurs in a variety of circumstances which may be roughly divided into infections and fall in proximal or distal mesenteric flow rate, the infectious and circulatory mechanisms often coexisting. Little information on the diagnosis is provided by clinical and paraclinical data. Management is medical and/or surgical; it includes alleviation of the symptoms in intensive care unit, attempts at producing local vasodilation whenever possible and resection of the intestinal segment affected. In many cases the diagnosis is made at exploratory laparotomy. The prognosis is poor; it depends on the patient's age, on the extent of the lesions which sometimes require wide intestinal resections, and on the time to diagnosis.

Anti-Bacterial Agents↗

PubMed1983

Necrotizing vasculitis in athymic rats with infarct kidney hypertension.

Infarct kidney hypertension was induced in congenital athymic nude rats and in their haired normal littermates. In both groups a significant and similar elevation of blood pressure was observed. The mesenteric vessels were studied histologically five, 12 and 20 days after operation. Necrotizing vasculitis with and without perivascular inflammatory reactions was found in mesenteric arteries and arterioles in six out of six athymic and in six out of 11 control rats. In sham operated athymic rats and in haired littermates neither hypertension nor vasculitis was observed. These observations indicate that the thymus play no role in the pathogenesis of acute hypertensive vascular disease.

Animals↗

PubMed2000

Embolization of a mesenteric arteriovenous fistula following pancreatic allograft: the steal effect.

The first pancreatic transplant was performed in 1966 by Kelly and Lillehei at the University of Minnesota (1, 2). Nearly 30 years later, Ozaki et al., published the first occurrence of an arteriovenous fistula (AVF) in a transplanted allograft bundle (3). From its early days as a radical and experimental procedure in the treatment of insulin-dependent diabetes mellitus, this operation has progressed to become routine in many major medical centers. However, the incidence of technical complications remains relatively high, ranging from 10 to 40% (1). The list of potential complications includes allograft pancreatitis, vascular thrombosis, hemorrhage, pseudoaneurysm formation, anastomotic leaks, intra-abdominal infections, and, al. though rare, AVF. Lowell et al., in 1993, reported this last complication in 3 of 90 consecutive pancreatic recipients (4). These same authors promoted the theory that AVF formation was directly related to procurement technique: a nonspecific "blind ligation" of mesenteric vessels along the inferior pancreatic border. However, this approach continues to be used commonly. We have identified the occurrence of an allograft superior mesenteric artery-superior mesenteric vein (SMA-SMV) AVF in a pancreas-after-kidney (PAK) transplant recipient.

Adult↗

PubMed1990

[X-ray computed tomographic aspects of mesenteric panniculitis].

Mesenteric panniculitis also known as lipodystrophy is an inflammatory condition of adipose tissue. A case of a 55 year old, female who presented a weight loss and a tender palpable mass located in the left flank is reported. CT patterns were not specific but might suggest the diagnosis: fatty mass, with a higher density than subcutaneous fat, located in the root of the mesentery and surrounding mesenteric vessels without distoting them. Intestinal loops were only pulled in periphery. This signs are not always present and even in this typical pattern mesenteric panniculitis could not be differentiated from liposarcoma. Thus an histological proof was needed. The evolution was good, with resolution of the abdominal pain. The knowledge of this rare Radioclinical syndrome should prevent any aggressive therapy.

Abdominal Neoplasms↗

PubMed1986

Drug treatment of changes in platelet-vessel wall interactions in burned rats.

The interaction between blood platelets and the walls of blood vessels is changed after burn injury to rats and guinea-pigs. Treatment of burned experimental animals with heparin, nicotinic acid, thrental, phytin, glutamic acid and alpha-tocopherol inhibited the increase in platelet-vascular wall interaction, improved the microcirculation in mesenteric vessels and increased the endurance of the animals to physical stress.

Animals↗

PubMedDate not supplied

Decreased response to vasopressin in the mesenteric resistance arteries of pregnant rats: effects of nifedipine and Bay K 8644.

OBJECTIVE: The purpose of this study was to investigate the contribution of potential-operated calcium (POC) channels in the mechanisms of the blunted effects of vasoconstrictors on mesenteric resistance arteries during normal pregnancy. METHODS: Mesenteric resistance arteries of virgin and term pregnant rats were set up under optimum passive tension in wire myograph systems. Cumulative concentration-response curves of arginine8-vasopressin (AVP) were measured in the absence and presence of nifedipine or Bay K 8644, a blocker and an activator, respectively, of POC channels. Binding studies were performed on membrane preparations of the mesenteric vascular bed of both groups of rats using saturation with [3H]nitrendipine. RESULTS: The maximal response to AVP was statistically similar in the two groups of arteries. Pregnancy shifted the AVP concentration-response curves to the right. Nifedipine (1 mumol/L) similarly reduced the maximum response to AVP in arteries of both groups, but produced a larger increase in EC50, the concentration inducing 50% maximum response, in resistance arteries of virgin versus pregnant rats. Bay K 8644 did not affect the maximum tension reached with AVP. However, it increased the effects of small concentrations of AVP in arteries of both groups. This was more important in tissues of virgin than pregnant rats. Binding of [3H]nitrendipine to membrane preparations of mesenteric vessels was not modified by pregnancy. CONCLUSION: Our results suggest a reduced functional influence of POC channels in the myotropic effects of AVP on mesenteric resistance arteries in pregnancy. This decreased influence of POC channels may contribute to resistance of the vasculature to vasopressor agents during pregnancy.

3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗

PubMed1976

Chronic mesenteric arterial insufficiency: results of revascularization in 33 cases.

The symptoms of mesenteric arterial insufficiency and the advantages of surgical revascularization have become widely recognized in recent years. Follow-up data are accumulating on patients who have had surgery for revascularization. In this study we report on 33 patients who had mesenteric revascularization for intestinal angina. Twenty-nine patients presented with postprandial pain; most had weight loss. Abdominal bruits were heard preoperatively in 26 patients. Aortogram demonstrated involvement of one mesenteric vessel in 13 (39%) patients and two or more vessels in 20 (61%). Revascularization was accomplished with the use of a Dacron graft or an autogenous vein bypass graft to 48 vessels. Endarterectomy and patch angioplasty were done once. One patient died in the early postoperative period. Of the other 32 patients, 30 (94%) had relief of symptoms. Eight patients died from 8 to 135 months after operation, but only one died from mesenteric vascular occlusion and bowel infarction. Five years after operation, 83% of the patients were alive; in ten years, 62%.

Adult↗

PubMed2004

Endovascular management of chronic mesenteric ischemia.

Chronic mesenteric ischemia is a rare condition caused by occlusive disease of the mesenteric vessels. While the traditional therapy in symptomatic patients has been surgery, recent advances in interventional devices and techniques have made endovascular treatment feasible and effective. Mesenteric angioplasty and stenting has a technical success rate of 80 to 100% with a clinical efficacy of 80 to 95%. Published studies indicate a primary patency of 75 to 85%. This article presents a review of the literature and the technical aspects of the procedure.

Angioplasty↗

PubMed1985

[Mesentericography: role of intra-arterial DSA in acute occlusive disease].

This study was carried out to evaluate the intra-arterial DSA method for diagnosis of occlusions of the mesenteric vessels. DSA examination in 24 patients (sup. mes. a.n = 24, inf. mes. a.n = 2) demonstrated that image quality was diagnostic in 84%, i.e. contrasting of mesenteric artery including the peripheral branches, when 10 ml of the contrast medium was injected selectively. In 63% of examinations the mesenteric venous return could be documented. Causes of DSA failure were image artefacts due to reduced patient's cooperation and bowel motion. Otherwise the obvious advantage of i.a. DSA was an immediate diagnostic imaging in patients with severe occlusive vascular disease using a manual administration of only small volumes of contrast material.

Angiography↗

PubMedDate not supplied

Volume-rendered 3D CT of the mesenteric vasculature: normal anatomy, anatomic variants, and pathologic conditions.

Multi-detector row computed tomography (CT) offers important advantages over more conventional imaging methods in the evaluation of the mesenteric vasculature. It allows faster scanning, which practically eliminates motion and breathing artifacts, as well as thinner collimation. These advances, coupled with rapid intravenous administration of contrast material, allow excellent opacification of the mesenteric arteries and veins. This improves the quality of the three-dimensional (3D) data sets, which in turn leads to improved 3D vascular maps and more accurate assessment of various conditions such as arterial or venous encasement in patients with pancreatic cancer, mesenteric ischemia, or inflammatory bowel disease. Three-dimensional multi-detector row CT also allows better visualization of arterial and venous branching, thereby improving detection of more distal vascular involvement. In addition, 3D multi-detector row CT may help detect hemodynamic changes in patients with active inflammation and hyperemia of a bowel segment because it can be used to measure bowel wall enhancement over time. Carcinoid tumors that have infiltrated the mesentery have a characteristic CT appearance, and other conditions such as lymphoma or sclerosing mesenteritis can also manifest as an infiltrating mass that envelops mesenteric vessels. Three-dimensional multi-detector row CT represents a significant advance in CT technology and can help ensure prompt, accurate evaluation of the mesenteric vasculature.

Humans↗

PubMed1975

Superior mesenteric blood flow during experimentally induced dumping in man.

The superior mesenteric circulation was studied with a dye-dilution technique after catheterization of the superior mesenteric artery and vein during provoked dumping in 5 patients. Dumping was provoked by intrajejunal instillation of 150 ml 50% glucose. A marked increase of, on the average, 157% was recorded in the superior mesenteric blood flow within a few minutes of the installation of glucose. The maximal increase in the flow was, on the average, 223% and occurred about 40 minutes after provocation. The instillation of glucose was promptly followed by a reduction in vascular resistance of the superior mesenteric vessels by 63% which decreased further to a mean maximal reduction of 76% below the resting level. The increase in the ratio between the superior mesenteric blood flow and cardiac output from 12 to 27% following instillation of glucose further underlines the pronounced vasodilatation of the small intestine. Superior mesenteric angiography at different intervals after provocation of dumping showed that the increased superior mesenteric blood flow is due to a local increase in the flow.

Aged↗

PubMed1986

Surgical repair of visceral artery occlusions in Takayasu's disease.

We describe the surgical management of six patients with occlusive disease of the visceral arteries caused by Takayasu's arteritis. All patients suffered from renovascular hypertension and, in addition, three of the patients also had symptoms of mesenteric angina. Surgical repair is recommended in the "burn-out" phase of the disease when further progression of the disease is unlikely. Revascularization of the kidneys was by autotransplantation to the iliac vessels. Mesenteric or celiac artery inflow was provided by an extra-anatomic vein bypass graft from the iliac artery. In all cases distal disease-free vessels were available for reconstructive surgery.

Adolescent↗

PubMedDate not supplied

Pancreatic uncinate carcinoma: sonographic findings.

BACKGROUND: Pancreatic carcinoma arising from the uncinate process (pancreatic uncinate carcinoma) is relatively rare. We wished to define its clinical manifestations and sonographic findings. METHODS: Clinical and sonographic data of eight cases were reviewed. RESULTS: The common bile duct and the pancreatic duct were not dilated until a very late stage. The lesion mimicked a mesenteric tumor in two cases. The superior mesenteric vessels were compressed anteriorly. Computed tomography was useful, not only for confirming the pancreatic uncinate origin of the lesion but also for determining precisely the mode of mesenteric vascular involvement. CONCLUSION: Knowledge of these unusual sonographic findings can determine the diagnostic strategy in pancreatic uncinate carcinoma.

Aged↗

PubMed1979

Prophylactic revascularization of the gut.

Reconstitution of the mesenteric vascular circulation, in our experience, is advisable when advanced occlusive disease is noted on the preoperative arteriogram of patients selected for aortoiliofemoral, renal artery, or aortic aneurysm surgery. A lateral aortogram is mandatory, and the presence of an anastomotic meandering mesenteric artery on frontal arteriogram is especially valuable in signaling significant disease. This is the first report of prophylactic concomitant revascularization of compromised mesenteric vessels during aortic reconstructive procedures on selected patients. It is our opinion that such an approach can be a significant deterrent to subsequent catastrophic bowel infarction from mesenteric arterial occlusive disease.

Celiac Artery↗

PubMed2005

Parathyroid hormone-related protein-induced relaxation of rat uterine arteries: influence of the endothelium during gestation.

OBJECTIVE: Parathyroid hormone-related protein (PTHrP) has been reported to relax different vessels. We investigated the influence of both endothelium and gestation on the relaxation of uterine arteries (UA), which supply blood to myometrium and placenta. METHODS: Small uterine and mesenteric arteries (MA) with (E+) and without endothelium (E-) from day 20 pregnant (P) and nonpregnant (NP) rats were mounted in a myograph, precontracted with phenylephrine (PE) in a physiologic salt solution. Relaxations to PTHrP, acetylcholine, and forskolin were performed and expressed as a percentage of the PE-induced contraction. Blockade of nitric oxide (NO) and endothelium-derived hyperpolarizing factor (EDHF) was also studied with Nomega-nitro-L-arginine methyl ester (L-NAME) and with charybdotoxin + apamin, respectively. RESULTS: Gestation significantly increases maximal vasodilating effect of acetylcholine in UA (68% vs 52%, P < .05) and sensitivity to acetylcholine in small mesenteric vessels (P < .05). PTHrP relaxes uterine (maximal relaxation P: 32%, NP: 46%), as well as small MA (P: 68%, NP: 89%), but the maximal relaxation is significantly greater in NP than in P rats (P: 32%, NP: 46%, P < .01) in both vascular beds. In addition, in the UA of P rats, PTHrP only produces relaxation if functional endothelium is present; nevertheless in the absence of endothelium, forskolin still elicits relaxation (65%, P < .01). L-NAME significantly impairs relaxation of E+ UA (P < .05), and so does the association of charybdotoxin + apamin (P < .05). Thus, NO and EDHF contribute largely to this vasorelaxant effect. CONCLUSION: PTHrP induces a relaxation on UA that is strongly endothelium-dependent during gestation, in contrast to what happens simultaneously in MA.

Animals↗

PubMed2003

Acute cardiovascular effects of sibutramine in conscious rats.

Sibutramine is a serotonin and norepinephrine reuptake inhibitor, used in the treatment of obesity. In this study, cardiovascular effects of sibutramine (0.9, 3, or 9 mg kg(-1) i.p.) were measured in conscious Sprague-Dawley rats, in the absence and presence of beta- and/or alpha-adrenoceptor antagonism (with propranolol and/or phentolamine, respectively). Sibutramine caused pressor and tachycardic effects, with celiac and mesenteric vasoconstrictions, and hyperemic hindquarters vasodilatation. Pretreatment with propranolol inhibited the tachycardic and hindquarters vasodilator effect of sibutramine, whereas phentolamine inhibited the pressor and vasoconstrictor effects of sibutramine. In the presence of phentolamine, sibutramine caused hyperemic mesenteric vasodilatation. In preconstricted, isolated, mesenteric vessels, sibutramine and its metabolites BTS 54505 (N-desmethylsibutramine) and BTS 54354 (N-didesmethylsibutramine) (10 microM) produced significant vasodilations. Neither sibutramine nor BTS 54505 enhanced vessel sensitivity to norepinephrine, whereas BTS 54 354 produced a significant leftward shift in the concentration-response curve to norepinephrine. Collectively, the results indicate that the overt cardiovascular effects of sibutramine involve alpha-adrenoceptor-mediated celiac and mesenteric vasoconstrictions, and beta-adrenoceptor-mediated hindquarters vasodilatation and tachycardia. The mesenteric vasodilator response to sibutramine, seen in the presence of phentolamine, may be a direct effect of the drug and/or its metabolites, on vessel tone. The cardiovascular effects of sibutramine in vivo may be secondary to inhibition of peripheral and/or central reuptake of monoamines by the metabolites BTS 54354 and/or BTS 54505. It remains to explain why BTS 54354, but not BTS 54505, enhanced norepinephrine sensitivity in vitro, because both metabolites are potent inhibitors of the norepinephrine transporter.

Animals↗

PubMed1998

Angiotensin II induces vascular smooth muscle cell replication independent of blood pressure.

The purpose of this investigation was to evaluate the role of blood pressure in the proliferative response of vascular smooth muscle cells to systemic infusion of angiotensin II (Ang II). Our laboratory has previously shown that infusion of Ang II induces smooth muscle cell proliferation in rat mesenteric vessels and carotid arteries. Ang II, a strong vasopressor, raised systolic blood pressure in rats from 120 to 200 mm Hg at a dose of 435 ng x kg(-1) x min(-1) after 1 week of treatment. The question arises as to whether this development of hypertension is a primary contributor to the replicative activities observed in the arterial wall of the mesenteric arteries or the carotid arteries or whether Ang II alone, without an increase in blood pressure, is sufficient to stimulate proliferation in these vessels. In the previous studies, we found that Ang II stimulated smooth muscle cell replication in the carotid artery and in type III and type I mesenteric microvessels. This study demonstrates that although administration of hydralazine normalizes the animals' blood pressures, it does not suppress the mitogenic effect of Ang II. Thus, it appears that Ang II has a direct effect on cell proliferation.

Angiotensin II↗