[Surgery of mesenteric vessels: prevention of mesenteric infarction].
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Acute Disease↗
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Distal ileocolic intussusception: another cause of inversion of superior mesenteric vessels in infants.
OBJECTIVE: Inversion of the superior mesenteric vessels is associated with various conditions. The purpose of this study was to prospectively evaluate the position of these vessels in infants with idiopathic ileocolic intussusception. SUBJECTS AND METHODS: Abdominal sonography was performed before and after reduction of ileocolic intussusception in 16 infants. RESULTS: In 14 infants with ileocolic intussusception proximal to the splenic flexure, the relationship of the superior mesenteric vessels was normal (superior mesenteric vein to the right ventral side of superior mesenteric artery). Inversion of the superior mesenteric vessels (superior mesenteric vein to the left of the superior mesenteric artery) was found in two patients with distal ileocolic intussusception (head of the intussusceptum at the sigmoid colon or rectum). After reduction, the relationship of these vessels was normal in all 16 infants. CONCLUSION: Inversion of the superior mesenteric vessels is sometimes caused by distal ileocolic intussusception in infants.
Colon, Sigmoid↗
Involvement of superior mesenteric vessels and portal vein in pancreatic adenocarcinoma: detection with CT during arterial portography.
A prospective study was designed to determine the utility of computed tomography (CT) during arterial portography (CTAP) in the detection of superior mesenteric vessels and portal vein involvement in patients with pancreatic adenocarcinoma. Eighteen patients with adenocarcinoma of the head of the pancreas and eight patients with benign pancreatic disease were investigated with CTAP, dynamic contrast-enhanced CT, and angiography. Appropriate review was made to determine presence or absence of superior mesenteric vessels and portal vein involvement. Final diagnosis was obtained in all cases by surgical explorations. The overall accuracy rate for detecting or excluding superior mesenteric vessels and portal vein involvement was 96% (25 of 26 patients) with CTAP, 88% (23 of 26 patients) with dynamic contrast-enhanced CT, and 85% (22 of 26 patients) with angiography. No statistically significant difference in accuracy was found among the three techniques. Our results suggest that the use of CTAP is not indicated in the preoperative detection of superior mesenteric vessels and portal vein involvement in patients with pancreatic adenocarcinoma.
Adult↗
A randomised controlled comparison of injection, thermal, and mechanical endoscopic methods of haemostasis on mesenteric vessels.
BACKGROUND AND AIMS: A randomised controlled comparison of haemostatic efficacy of mechanical, injection, and thermal methods of haemostasis was undertaken using canine mesenteric vessels to test the hypothesis that mechanical methods of haemostasis are more effective in controlling haemorrhage than injection or thermal methods. The diameter of arteries in human bleeding ulcers measures up to 3.45 mm; mesenteric vessels up to 5 mm were therefore studied. METHODS: Mesenteric vessels were randomised to treatment with injection sclerotherapy (adrenaline and ethanolamine), bipolar diathermy, or mechanical methods (band, clips, sewing machine, endoloops). The vessels were severed and haemostasis recorded. RESULTS: Injection sclerotherapy and clips failed to stop bleeding from vessels of 1 mm (n = 20) and 2 mm (n = 20). Bipolar diathermy was effective on 8/10 vessels of 2 mm but failed on 3 mm vessels (n = 5). Unstretched elastic bands succeeded on 13/15 vessels of 2 mm but on only 3/10 vessels of 3 mm. The sewing machine achieved haemostasis on 8/10 vessels of 4 mm but failed on 5 mm vessels (n = 5); endoloops were effective on all 5 mm vessels (n = 5). CONCLUSIONS: Only mechanical methods were effective on vessels greater than 2 mm in diameter. Some mechanical methods (banding and clips) were less effective than expected and need modification. Thermal and (effective) mechanical methods were significantly (p < 0.01) more effective than injection sclerotherapy. The most effective mechanical methods were significantly more effective (p < 0.01) than thermal or injection on vessels greater than 2 mm.
Animals↗
[Effect of volatile fatty acid concentration in the rumen on blood flow in the mesenteric vessels of sheep].
The studies were performed on sheep with chronic rumen fistulae and implanted electromagnetic recorders of blood flow in the anterior mesenteric vein and the anterior mesenteric artery. The animals were fed the diet consisting of sugar beet, urea and mineral salts (diet I) or sugar beet and mineral salts (diet II--nitrogen deficient). The diet caused an increase of blood flow in the mesenteric artery and the mesenteric vein: this increase reached the highest level after 2 hours since the application of the diet. There was noted a positive correlation between the changes of blood flow in the mesenteric vessels and the volatile fatty acid concentration in the rumen. The composition of the diet, differing by a protein level, did not influence significantly the differences in blood flow in the mesenteric vessels. It was suggested that an increase of blood flow in the mesenteric vessels was caused by fermentation of carbohydrates in proventriculi, and hence an increased concentration of VFA in the content attaining the duodenum, stimulation of chemoreceptors in the rumen mucosa and increased activity of cholinergic system in internal organs of the abdominal cavity.
Animal Feed↗
Congenital arteriovenous fistula of the superior mesenteric vessels.
Arteriovenous (AV) fistula of the mesenteric vessel is a rare lesion and is most often iatrogenic or traumatic in origin. An infant boy with congenital superior mesenteric AV fistula is described. The present case is the first reported in a newborn.
Arteriovenous Malformations↗
Effect of low-molecular-weight heparins on laser-induced thrombus formation in rat mesenteric vessels.
Laser-induced thrombi have been frequently produced in rat mesenteric vessels to investigate the effect of antithrombotic drugs. We have tested low molecular heparins in comparison to unfractionated heparin. The investigations were carried out on male Wistar rats weighing 200-300 g; the animals were anesthetized with pentobarbital sodium (Nembutal) 60 mg/kg i.p. Vascular lesions were induced with a Coherent CR-2 supergraphite ion laser (argon laser) mounted on a Leitz Orthoplan microscope. An intestinal loop was spread on a self-constructed object stage, mounted on the microscope table. The laser beam was directed through the optical path of the microscope on small mesenteric vessels in the fat-free portion of the mesentery. For the evaluation of thrombus formation the number of laser injuries needed to induce a defined thrombus was used. All low-molecular-weight heparins (preparation B, Braun; BR-Z-0601, Braun; CY 216, Choay; Fragmin, Kabi; low molecular heparin, Sandoz and Org 10172, Organon) or unfractionated heparin (Liquemin; Hoffmann-La Roche) showed a significant and dose-dependent antithrombotic effect after subcutaneous injection, if venules had been damaged. The effect lasted for 48 h, partly for over 48 h. If thrombus formation was studied after intravenous injection into arterioles as well as into venules 8 h after injection, no antithrombotic effect could be demonstrated under the influence of CY 216 or unfractionated heparin.
Animals↗
[Two children with suspected primary vasculitis of mesenteric vessels--a case report].
We reported 2 children with suspected primary vasculitis of mesenteric vessels. Both children were admitted to our hospital with the complaints of abdominal pain, bloody stool or diarrhea. Laboratory examination simultaneously revealed leukocytosis with dominant neutrophils, positive CRP, and hypoalbuminemia. Although prothrombin time and activated partial thromboplastin time were within normal limits, the increased levels of FDP-E, D-dimer, and von Willebrand factor activity were observed, which suggested the endothelial cell activation and the coagulation/fibrinolysis system activation. Abdominal echography and CT scanning demonstrated the edematous thickening of intestinal or colon walls probably due to the vasculitic permeability changes of mesenteric artery. During the disease courses, skin rash, bleeding tendency, arthritis and proteinuria were not observed, and no autoantibodies including anti-nuclear antibody, anti-DNA antibody, and myeloperoxidase-antineutrophil cytoplasmic antibody, were detected. Taken together, we suspected these children as restricted vasculitis of mesenteric vessels. Intravenous prednisolone was administrated, and the clinical and laboratory abnormalities recovered completely within 2 weeks. Thus, we suggested that the leukocyte counts, CRP, and the determination of von Willebrand factor and coagulation/fibrinolysis study accompanied with X-ray, echography, and CT scanning will be useful for the early diagnosis of vasculitis before the pathologic and irreversible vascular damage are demonstrated.
C-Reactive Protein↗
Simultaneous measurement of intracellular pH, calcium, and tension in rat mesenteric vessels: effects of extracellular pH.
In rat mesenteric vessels changes in external pH (pHo) alter tension. Changes in intracellular pH (pHi) and calcium ([Ca2+]i) have both been suggested to underlie the tension changes. As no simultaneous measurements of pHi and [Ca2+]i had been made, however, the relative importance and temporal relationship between pHi [Ca2+]i and tension were unknown. In order therefore to gain a clearer understanding of the mechanisms involved, we have made simultaneous measurements of these parameters using carboxy-SNARF and INDO-1. Raising pHo caused rises in pHi, Ca2+ and tension. The increases in pHi preceded increases in [Ca2+]i, which preceded the increases in tension. Similar but opposite effects were observed when pHo was decreased. We conclude that the change in [Ca2+]i upon alteration of pHo is subsequent to that of pHi.
Animals↗
Effects of digoxin on islated human mesenteric vessels.
Digoxin had contractant effects on isolated, human mesenteric arteries and veins. Veins were more sensitive to this action of the glycoside than arteries. The contractions were not affected by phentolamine or by washing with a digoxin-free solution. However, they were abolished by the calcium antagonist nifedipine, and by washing with a calcium-free medium. In the presence of digoxin, the maximum response to noradrenaline (1.8 x 10(-5) M) increased markedly in both arteries and veins, and the concentration-response curve for the amine was displaced to the left. Immersion of vein preparations in calcium-free solution for 30 min. abolished the digoxin contracture; an increase in extracellular calcium restored the response. Changes in extracellular potassium concentration caused changes in tension in tension of the mesenteric veins similar to those previously demonstrated in peripheral veins--both in the presence and in the absence of digoxin. It is concluded that digoxin contracts mesenteric vessels by a direct action on the muscle cells, and potentiates the contractant effects of noradrenaline. These effects are dependent on the availability of extracellular calcium. Mesenteric vascular reactions caused by changes in extracellular potassium are influenced by digoxin.
Aged↗
[Thrombosis of the mesenteric vessels as a complication of food toxicoinfection].
The authors have observed 189 patients with thromboses of the mesenteric vessels. In 85.7% of the cases thrombosis developed in the mesenteric major vessels (mainly in the upper mesenteric artery), in 14.3% in the microcirculation system as a complication of food poisoning. Differential-diagnostic signs for both groups and clinical illustrations are presented. The importance of efficient rehydration therapy in food poisoning for the correction of rheological and homeostatic disorders in the microcirculation system is emphasized.
Adult↗
Traumatic injury to the proximal superior mesenteric vessels.
Twenty-one patients were treated for 25 injuries to the proximal superior mesenteric vessels (eight, superior mesenteric artery; nine, superior mesenteric vein; four, superior mesenteric artery plus superior mesenteric vein). Mechanisms of injury were stab wounds (11 cases), motor vehicle accidents (9 cases), and iatrogenic (one case). Ten patients (48%) arrived at the emergency room in shock (two with no obtainable case blood pressure). Superior mesenteric artery repair was performed by lateral suture (seven cases), end-to-end anastomosis (three cases), autogenous vein graft (one case), and no repair (one case). All 13 venous injuries were repaired by lateral suture. Four patients (19%) died in the operating room secondary to acute blood loss and irreversible shock. There were no late deaths and no second-look operations. Further improvement in survival depends on rapid transportation from injury site to operating room.
Accidents, Traffic↗
Haeme oxygenase mediates hyporeactivity to phenylephrine in the mesenteric vessels of cirrhotic rats with ascites.
BACKGROUND AND AIMS: Haeme oxygenase could play a role in the pathogenesis of arterial vasodilation in cirrhosis. The aim of this study was to verify the role of haeme oxygenase in the hyporesponsiveness to phenylephrine of small mesenteric arteries in rats with CCl(4) induced cirrhosis, with and without ascites. METHODS: Pressurised small resistance mesenteric arteries were challenged with increasing doses of phenylephrine. Dose-response curves were evaluated under basal conditions, after inhibition of haeme oxygenase with chromium-mesoporphyrin, after inhibition of nitric oxide synthase (NOS) with N(G)-nitro-L-arginine-methyl-ester (L-NAME), and then after inhibition of both NOS and haeme oxygenase. Haeme oxygenase protein expression was also analysed. RESULTS: Twenty six control rats and 35 rats with cirrhosis (17 with and 18 without ascites) were studied. Response to phenylephrine was lower in non-ascitic and ascitic cirrhosis than in controls. Chromium-mesoporphyrin increased the response to phenylephrine only in ascitic cirrhosis (p<0.001). L-NAME increased the response to phenylephrine in controls (p<0.001) and in ascitic and non-ascitic cirrhosis (p = 0.002, p<0.001, respectively) but the final response in non-ascitic cirrhosis was similar to that of control rats while it remained impaired in ascitic cirrhosis. Addition of chromium-mesoporphyrin to L-NAME improved the response to phenylephrine in ascitic cirrhosis (p<0.01), with final values not different from those of the other two groups. Protein expression of the inducible isoform of haeme oxygenase was increased in the mesenteric vessels of cirrhotic rats. CONCLUSION: Haeme oxygenase mediates hyporeactivity to phenylephrine in the mesenteric vessels of experimental cirrhosis with ascites. NOS plays a major role only in the first stage of the disease.
Animals↗
Multislice CT angiography of mesenteric vessels.
Due to several distinct advantages over conventional angiography (including minimal invasiveness, lower cost, and lower ionizing radiation exposure for patients and staff), computed tomography (CT) angiography has replaced diagnostic conventional angiography in several clinical situations. The recent introduction of multislice CT (MSCT) scanners has significantly improved CT angiographic applications, especially in the evaluation of the mesenteric vasculature. Thin-slice collimation protocols associated with powerful postprocessing procedures allow the display of mesenteric circulation with excellent detail. The purposes of this presentation are (a) to illustrate the imaging technique that can be used to obtain state-of-the-art MSCT angiographic images of the mesenteric vasculature, (b) to review the normal anatomy and anatomic variants of mesenteric vessels, and (c) to illustrate some of the potential clinical applications of MSCT angiography of the mesenteric vessels.
Angiography↗
ETA and ETB receptors on vascular smooth muscle cells from mesenteric vessels of spontaneously hypertensive rats.
1. To investigate the contribution of ETA and ETB receptors, calcium responses to the ETB agonist, IRL-1620, to endothelin-1 (ET-1) and to the ETA antagonist, BQ-123, were examined in primary cultured unpassaged vascular smooth muscle cells (VSMC) from mesenteric vessels of 3, 9 and 17 week old spontaneously hypertensive rats (SHR), Wistar and Wistar-Kyoto (WKY) rats using Fura-2 methodology. 2. IRL-1620 (10(-7) mol/L) and ET-1 (10(-9) mol/L) increased [Ca2+]i in all strains and ages. Responses to ET-1 and IRL-1620 were blunted in 17 week SHR. BQ-123 significantly reduced ET-1-stimulated [Ca2+]i. In endothelium-denuded mesenteric vessels, ET-1 and IRL-1620 induced significant [Ca2+]i responses. 3. Binding of ET-1 was significantly lower in mesenteric artery membranes from 17 week SHR compared to controls. 4. Thus, ETA and ETB receptors are present in rat mesenteric VSMC. In adult SHR, a reduced density of ET receptors results in decreased responses to IRL-1620 and to ET-1.
Animals↗
Traumatic arteriovenous fistula of the superior mesenteric vessels.
A case of traumatic arteriovenous fistula of the superior mesenteric vessels is added to a collective review of 16 previous cases. Nausea, vomiting, cramping abdominal pain, diarrhea, abdominal thrill and bruit were usually present. Arteriography was diagnostic. Four patients operated upon immediately or within 11 hours after penetrating abdominal trauma had superior mesenteric arteriovenous injuries repaired; the remainder had a mesenteric vascular injury missed at initial laparotomy. The location of the fistula determined the method of repair. Spontaneous obliteration occurred in one patient. In two of the three deaths, portal hypertension was persent and a fistula was discovered at autopsy; the other occurred 3 months after massive bowel resection. Thorough exploration of hematomas and lacerations of the mesentery will minimize or eliminate subsequent formation of an arteriovenous fistula.
Abdominal Injuries↗
Disruption of microtubular network attenuates histamine-induced dilation in rat mesenteric vessels.
Cytoplasmic microtubules are important in many cellular homeostatic processes in the cell. They regulate cell shape and movement as well as serving as a network by which vesicles and membrane-bound organelles can travel. Lately, there have been many studies demonstrating that microtubules are involved in regulation of intracellular signaling and, therefore, affect vascular reactivity. In this study, we tested the hypothesis that microtubule disruption attenuates agonist-induced endothelium-dependent vasodilation. Isolated mesenteric arterial bed from normotensive rats was preconstricted with phenylephrine, and dose-response curves for histamine, acetylcholine (ACh), sodium nitroprusside (SNP), and pinacidil were performed before and after incubation with nocodazole or colchicine. Treatment of the vascular beds with nocodazole or colchicine significantly attenuated histamine relaxation but did not change the ACh-, SNP-, or pinacidil-induced vasorelaxation. Nocodazole did not cause an additional attenuation of the histamine-mediated dilation in mesenteric vessels in the presence of Nomega-nitro-L-arginine methyl ester, high extracellular K+, or K+ channel blockers. These data suggest that disruption of microtubules affects an essential endothelial component of histamine-mediated vasodilation in the mesenteric arterial bed. The mechanism(s) involved in this effect might be related to an impairment of endothelial NO synthesis, which might not be as important for the ACh as for the histamine vasodilator response in rat mesenteric vessels. These results demonstrate the importance of the microtubular system for endothelium-dependent NO-mediated smooth muscle relaxation.
Animals↗
Regional differences in electrical and mechanical properties of guinea-pig mesenteric vessels.
Regional differences in electrical and mechanical properties of guinea-pig mesenteric vessels were investigated using microelectrode and isometric tension recording methods. The amplitude of membrane potentials differed according to region and in the following order; branch of jejunal artery (BJA) > cranial mesenteric artery (CMA) > jejunal artery (JA) greater than or equal to jejunal vein (JV) not equal to portal vein (PV). There were also regional differences in the muscle membrane potential with various concentrations of [K]o or [Na]o, while no differences were observed with applications of various concentrations of [Ca]o or [Cl]o. ACh produced hyperpolarization of the muscle membrane in the CMA, JA and JV but not in the PV and BJA. Hyperpolarization in the JA mainly followed increase in the K-permeability, and a reversal potential for ACh was distributed at about -70mV. In the JV, the ACh-induced hyperpolarization accompanied tension development. Phenylephrine depolarized the muscle membranes of the CMA, JA and PV but not of the BJA and JV. Low concentrations of phenylephrine produced contractions with no depolarization of the membrane in the JA and CMA. Isoprenaline-induced hyperpolarization was smaller in arteries than in veins, and this hyperpolarization was reduced in amplitude with repeated applications. The ACh-induced relaxation and phenylephrine-induced contraction were larger in the JA than in the CMA. Regional differences of the muscle property in response to application of different agents were discussed in relation to the physiological roles.
Animals↗