1. Mesenteric Infarction: Clinical Outcomes After Restoration of Bowel Continuity.
- Author
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Adaba F, Rajendran A, Patel A, Cheung YK, Grant K, Vaizey CJ, Gabe SM, Warusavitarne J, and Nightingale JM
- Subjects
- Adult, Aged, Aged, 80 and over, Anastomosis, Surgical, Anticoagulants therapeutic use, Combined Modality Therapy, Female, Fluid Therapy, Humans, Infarction etiology, Logistic Models, Male, Mesenteric Ischemia etiology, Middle Aged, Retrospective Studies, Risk Management, Treatment Outcome, Colon surgery, Infarction therapy, Jejunostomy, Jejunum surgery, Mesenteric Ischemia therapy, Mesentery blood supply, Parenteral Nutrition
- Abstract
Introduction: Patients who have a bowel resection for mesenteric infarction may require parenteral nutrition (PN). This study primarily aimed to determine the aetiological factors for a mesenteric infarction and the effects of restoring bowel continuity on the long-term PN requirements., Methods: A retrospective review of data on patients treated for mesenteric infarction from 2000 to 2010., Results: A total of 113 patients (61 women, median age 54 years) were identified. Seventy-four (65%) had a superior mesenteric artery thromboembolism, 25 (22%) had a superior mesenteric vein thrombosis, and 4 (3%) had superior mesenteric artery stricture or spasm. Patients younger than 60 years most commonly had a clotting abnormality (n = 23/46, 50%), whereas older patients had a cardiological risk factor (n = 11/17, 65%). All patients with a jejunostomy required long-term PN. Fifty-seven (49%) patients had restoration of bowel continuity (colon brought into circuit). After this, PN was stopped within 1 year in 20 (35%), within 2 years in 29 (50%) patients and within 5 years in 44 (77%) patients (P = 0.001)., Conclusions: A thrombotic tendency is the main etiological factor in most patients younger than 60 years. An anastomosis of the remaining jejunum to the colon can allow PN to be stopped.
- Published
- 2015
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