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At least 19 recordsLinked to original sources
PubMed1977

Celiac axis, superior mesenteric artery, and inferior mesenteric artery occlusion: surgical considerations.

Occlusion of the celiac, superior mesenteric, and inferior mesenteric artery has been studied in 46 patients treated by operation. The condition was acute and was caused by embolic obstruction of the superior mesenteric artery in four cardiac patients and detachment of the inferior mesenteric artery in two patients during removal of infrarenal abdominal aortic aneurysms. The condition was chronic and involved two or all three of the vessels in 40 patient. Embolic obstruction caused severe abdominal pain but few physical signs early in the process,, but the picture of an acute abdomen indicating bowel gangrene developed in a few hours. Ischemia from inferior mesenteric detachment was observed at operation. Patients with chronic obstruction had abdominal pain, weight loss, and diarrhea. Patients with embolic obstruction were treated successfully by embolectomy, and patients developing intraoperative sigmoid ischemia were treated by reattachment of inferior mesenteric arteries to aortic graft. Various procedures were employed in patients with chronic multiple obstruction. However, graft bypass using Dacron tubing was preferable because of its simplicity and because the frequently (48%) associated occlusive disease and aneurysm of the distal aorta were treated at the same time. Confining operation to the abdomen significantly reduced the magnitude of operation and eliminated risks in this age group. Of the 46 patients, 91% survived and were relieved of their symptoms despite associated disease. The 5-year survival rate in this group of patients was 62%.

Adult↗
PubMedDate not supplied

Tube graft replacement of the suprarenal aorta with implantation of the superior mesenteric artery.

The superior mesenteric artery was successfully implanted to a tube graft replacement of the suprarenal abdominal aorta after a gunshot wound. Although injuries to the abdominal aorta carry a high mortality, adequate management and prompt operation can reduce the mortality rate. In cases like this one the ingenuity of the surgeon is at stake, because arterial anastomoses are not always possible to their natural origin. Death from aortic injuries is most commonly caused by hemorrhage and exsanguination, so appropriate measures must be taken as soon as the diagnosis is made to avoid this possibility. Also, patients should not be hypotensive for any long time, so transfusion should be timed carefully, especially when the aortic clamps are being removed.

Adolescent↗
PubMed1977

Hemodynamic reflex in muscle in response to brief occlusion of the mesenteric artery.

Brief occlusion of the superior mesenteric artery in the cat produces increases in systemic pressure and in muscle blood flow. Capillary filtration in muscle, measured during occlusion of the superior mesenteric artery, exceeds that of the controls. Propranolol, which blocks the evoked increase in muscle blood flow, reduces capillary filtration during occlusion to less than the control. Cutting the mesenteric nerve returns capillary filtration to the control level. Passive redistribution of blood, such as might follow occlusion of a large vascular region, is not the basis for the evoked changes in muscle hemodynamics. They are abolished by cutting the mesenteric nerve and by propranolol, and are demonstrable during constant pressure perfusion of muscle. The evidence suggests that occlusion of the mesenteric artery produces an increase in capillary filtration by balancing a reflex sympathetic beta-adrenergic vasodilation in pre-capillary resistance vessels with an increase in resistance in the precapillary sphincters.

Animals↗
PubMedDate not supplied

Comparison of the effect of vasopressin infusions on the mesenteric arteries of different species.

Superior mesenteric arteriography was performed following infusions of vasopressin, epinephrine and saline into the superior mesenteric arteries of dogs, pigs, rabbits and monkeys and compared with the well-known effects in human beings. Species-specific effects were noted and compared with the known differences in various vascular beds in human beings. In non-primate animals, vasopressin appeared to act at a more distal site than in primates, but with a similar decrease in superior mesenteric arterial flow. The results in primates were similar to those in human beings.

Adult↗
PubMed1976

Modification by prostaglandins E1 and E2, indomethacin, and arachidonic acid of the vasoconstrictor responses of the isolated perfused rabbit and rat mesenteric arteries to adrenergic stimuli.

In isolated perfused rabbit mesenteric arteries, prostaglandin (PG) E1 and E2, 1-5NG/ML, did not alter the basal perfusion pressure, but reduced the vasoconstrictor responses to sympathetic nerve stimulation; the responses to injected norepinephrine were reduced by PGE1 and variably affected by PGE2. In contrast, in rat mesenteric arteries PGE1 and PGE2, 1-5 ng/ml, potentiated the vasoconstrictor responses to nerve stimulation and to injected norepinephrine. In rabbit mesenteric arteries, the inhibitor of PG synthesis, indomethacin, augmented the responses to sympathetic nerve stimulation and to injected norepinephrine, whereas in rat mesenteric arteries indomethacin inhibited the responses to both adrenergic stimuli. Arachidonic acid, a PG precursor, reduced the vasoconstrictor responses to sympathetic nerve stimulation and to injected norepinephrine in rabbit, whereas in rat, potentiation of the responses to adrenergic stimuli occurred. Since these effects of arachidonic acid were abolished by the simultaneous infusion of indomethacin, they appear to be mediated through conversion of arachidonic acid to PG. We conclude that prostaglandins modulate adrenergic transmission in mesenteric arteries and this effect is species dependent.

Animals↗
PubMed1977

Diamine oxidase activity and histamine release in dogs following acute mesenteric artery occlusion.

Following superior mesenteric artery occlusion and revascularization in dogs all animals died in a circulatory collapse state. However, pretreatment by aminoguanidine, the strong and specific inhibitor of diamine oxidase, accelerated the circulatory break-down significantly and increased the venous plasma histamine concentrattions up to levels which also in normal dogs are effective in the circulatory system. Furthermore, the haematocrit increased significantly more in the aminoguanidine-treated animals than in the dogs treated by saline. No changes in plasma diamine oxidase activity were observed in saline-treated animals during intestinal ischemia and following revascularization. In aminoguanidine-treated animals no enzymic activity could be measured. The results were interpreted by a protective role of intestinal diamine oxidase in intestinal ischemia. Enhancement of the enzymic activity in patients, for instance by heparin, may be helpful in mesenteric infarction disease.

Amine Oxidase (Copper-Containing)↗
PubMed1978

Diagnostic value of hypotonic duodenography in superior mesenteric artery syndrome.

The superior mesenteric artery syndrome is a compression of the duodenum. We believe that the diagnostic limitations of the routine barium meal studies can be abolished by hypotonic duodenography. Before surgical treatment other pathological conditions should be excluded. Peptic ulcer disease often coexists. Patients with persisting signs and symptoms after surgery for ulcer should be re-examined with this condition in mind. The adequate treatment is duodenojejunostomy.

Adult↗
PubMed1978

Acute superior mesenteric arterial occlusion: a plea for early diagnosis.

Acute mesenteric arterial occlusion is a curable disease, provided it is diagnosed and treated before irreversible changes occur in the ischemic bowel. Forty patients treated for proven mesenteric arterial occlusion were evaluated retrospectively in an effort to broaden the existing criteria for early diagnosis. Twenty-three patients suffered from mesenteric thrombosis and 17 sustained embolic occlusion of the superior mesenteric artery. The overall mortality rate was 77.5% (31 of 40 patients). Three patients survived without bowel resection. The appearance of acute abdominal pain accompanied by profuse cold sweating in a cardiac patient with apparently normal abdomen, hyperactive bowel sounds, and a history of embolic events should always raise the suspicion of acute mesenteric ischemia and should be verified immediately by mesenteric angiography. A high index of suspicion, aggressive measures for early diagnosis, and early operative treatment are presently the only possibilities to provide a better outcome.

Acute Disease↗
PubMed1976

Iatrogenic embolization of the superior mesenteric artery: arteriographic observations and clinical implications.

Following sudden occlusion of the superior mesenteric artery, there is a characteristic and predictable pattern of blood flow through the instantaneously activated collateral channels. On the left, the first patent jejunal or ileal branch utilizes the central tier of the mesenteric arcades to revascularize the distal trunk of the occluded superior mesenteric artery. On the right, the anastomotic connection between the middle colic, right colic, and ileocolic arteries provides an efficient collateral pathway. These two collateral channels supplement each other and the distal trunk of the occluded superior mesenteric artery is usually rapidly reconstituted. Superior mesenteric artery embolization is frequently an asymptomatic event. There appears to be a variable tolerance of cardiac and non-cardiac patients to the effect of superior mesenteric embolization. Non-cardiac patients may tolerate embolization of the superior mesenteric artery quite well. Cardiac patients frequently respond with an ischemic crisis. The site of embolization is another determining factor. An embolus below the origin of the middle colic artery provides an incomparably more favorable hemodynamic situation than an embolus proximal to the origin of this vessel. The excellent tolerance of our group of patients to superior mesenteric embolization appears to be closely related to these two main factors.

Arteriosclerosis↗
PubMed1979

Relationship between histamine-induced changes of cyclic AMP and mechanical activity on smooth muscle preparations of the guinea-pig ileum and the rabbit mesenteric artery.

On guinea-pig ileum and rabbit mesenteric artery contracted by high potassium (100 mM) histamine produced relaxations which were inhibited by the H2-receptor antagonist metiamide. These results are thus indicative for the role of H2-receptors in mediating relaxation and for H1-receptors in mediating contraction on smooth muscle. Time course studies for the relaxing and cyclic AMP responses to histamine showed that the cyclic AMP increase preceded the H2-receptor mediated relaxation. The cyclic AMP increase in response to histamine was prevented by metiamide, but remained unaffected by mepyramine on both the guinea-pig ileum and the rabbit mesenteric artery. In addition, dose-response curves obtained on the mesenteric artery demonstrated that the H2-receptor mediated depressor responses coincided with cyclic AMP increases. Thus, these results gave clear-cut evidence that cyclic AMP is an intracellular metabolic event only implicit in the H2-receptor mediated relaxation, but not in the H1-receptor mediated contraction on smooth muscle preparations.

Animals↗
PubMed1978

Revascularization in mesenteric infarction by reimplantation of the superior mesenteric artery. Report of a case.

A case of revascularization in mesenteric infarction by reimplantation of the superior mesenteric artery combined with intestinal resection is presented. The patient had an acute occlusion of the superior mesenteric artery with coincident blockage of celiac axis and inferior mesenteric artery resulting in gangrene and perforation of the small bowel. The good postoperative recovery suggests the usefulness of this method in selected cases.

Aged↗
PubMed1978

Vasopressin: route of administration and effects on canine hepatic and superior mesenteric arterial blood flows.

BLOOD FLOWS THROUGH THE CANINE HEPATIC (HBF) AND SUPERIOR MESENTERIC ARTERIES (MBF) WERE MEASURED WITH ELECTROMAGNETIC FLOWMETERS, DURING INFUSIONS OF VASOPRESSIN, BY THREE ROUTES OF ADMINISTRATION: 1) intra-hepatic-arterially (IHA), 2) intra-portal-venously (IPV) and 3) intra-systemic-venously (IV). Mean control HBF was 148 +/- 17 (S.E.) ml min(-1); MBF was 243 +/- 27 ml min(-1); aortic pressure (AP) was 126 +/- 3 mm Hg; portal venous pressure (PVP) was 8.8 +/- 1.0 mm Hg. Infusions of vasopressin, at a rate of 5 x 10(-3) units kg(-1) min(-1), IHA, reduced HBF significantly (p < .001) to 121 +/- 21 ml min(-1), within one minute. Flow returned to control, despite continued drug infusion; and at the end of the fifth minute of infusion, the value (134 +/- 21 ml min(-1)) was not significantly (p > .05) different from control. During the same infusion, MBF fell to 129 +/- 28 ml min(-1) (p < .001), by the sixth minute of the infusion and remained at this level for the duration of the infusion. AP increased to 137 +/- 13 mm Hg, by the sixth minute of the infusion and was sustained at this level for the duration of the infusion. PVP decreased to 7.0 +/- 1.0 mm Hg, by the tenth minute of the infusion. The responses to IPV vasopressin were indistinguishable from those following IHA vasopressin, with the exception that HBF was reduced to only 147 +/- 22 ml min(-1) (from a preinfusion control of 160 +/- 23 ml min(-1)), at one minute. HBF returned to control, despite continuation of the infusion. IV vasopressin, at the same concentration, caused no change in HBF throughout the ten minute infusion. These observations indicate that the canine hepatic arterial circulation responds to vasopressin with vasoconstriction characterized by autoregulatory escape. By any of the three routes of administration, vasopressin causes a significant and sustained reduction in blood flow through the superior mesenteric artery. Autoregulatory escape, from vasopressin-induced mesenteric arterial constriction, is not observed. Based on these observations, significant changes in mesenteric arterial blood flow can be anticipated without associated significant changes in hepatic arterial blood flow, regardless of the route of administration of vasopressin.

Animals↗