Presentation
In our study, 50% of patients with malrotation presented within the first week of life, and 68% presented within the first month. [journals.lww.com]
Abstract Strangulated inguinal hernia may present with intestinal gangrene. However, mesenteric arterial thrombosis producing massive gangrene of the bowel as content in inguinal hernia is an entity probably not reported in the medical literature. [pubmed.ncbi.nlm.nih.gov]
We reviewed the presentation, diagnosis, surgical treatment and prognosis of internal mesenteric hernia. 2 CASE PRESENTATION A 25-year-old male patient presented to the emergency department of our hospital with a 3-day history of sudden severe generalized [onlinelibrary.wiley.com]
Subacute presentation is usually seen with longer disease duration, however when ischemia from mesenteric thrombosis becomes acute, clinical presentation is similar to those who have an acute mesenteric embolic episode [29]. [intechopen.com]
Entire Body System
- Ascites
Results Twelve of the 23 neonates who had a bedside abdominal US were found to have ascites with debris or complex ascites. One of these 12 patients improved with medical management, and the ascites resolved. [jpedsurg.org]
Thirty-seven abdominal USs were arranged, which revealed bowel obstruction with ascites in 21 patients. Among the 22 malrotation patients, 18 underwent abdominal US. [journals.lww.com]
Bloody ascites and large fluid losses in the third space may occur, leading to dehydration and hypotension, causing further propagation of venous thrombosis and worsening of the ischemic insult. [intechopen.com]
- Inguinal Hernia
Case Reports Intestinal gangrene due to mesenteric vascular occlusion masquerading as strangulated inguinal hernia S K Tiwary et al. Hernia. 2008 Apr. Abstract Strangulated inguinal hernia may present with intestinal gangrene. [pubmed.ncbi.nlm.nih.gov]
Gastrointestinal
- Severe Abdominal Pain
Bloating When to see a doctor Seek immediate medical care if you have sudden, severe abdominal pain. [mayoclinic.org]
The classic picture of a patient with acute mesenteric ischemia involves severe abdominal pain with a paucity of abdominal examination findings and a history of risk factors. [intechopen.com]
Clinical symptoms including fever, abdominal pain, vomiting (bilious or nonbilious), bloody stool, peritoneal signs, severe dehydration, and disease duration were reviewed. [journals.lww.com]
- Failure to Thrive
Failure to thrive was the major long-term complication in our patients. In previous studies, the mortality rate ranged from a low of 2.9% to a high of 50% (18,19). [journals.lww.com]
A clinical clue to the problem may be an unexplained worsening in the clinical condition or a failure to thrive or a failure in having the anticipated recovery course. [intechopen.com]
- Blood in Stool
[…] lipid levels that are too high) * Obesity The symptoms The symptoms of intestinal gangrene typically include abdominal pain (mild to severe), bloating, vomiting, diarrhea, blood in stools/dark coloured stools, fever. [indianexpress.com]
Fever, abdominal distention, and occult blood in stool are the most common findings. [intechopen.com]
- Intestinal Perforation
Free intestinal perforation was not demonstrated. The 3 infants in this group survived. Conclusions The presence of complex ascites with debris correlated well with intestinal gangrene or perforation. [jpedsurg.org]
A new intestinal perforation was seen at about 2 cm from the initial perforation. The intestinal perforation was exteriorized as an ileostomy, and the abdominal wound closed with tension sutures. [hindawi.com]
A hole through the wall of the intestines (perforation). A perforation can develop, which can cause the contents of the intestine to leak into the abdominal cavity. This may cause a serious infection (peritonitis). [mayoclinic.org]
- Hematochezia
He had no history of passage of melena or of hematochezia. His parents complained that he had been passing scanty urine for about five days before presentation. [hindawi.com]
Cardiovascular
- Thrombosis
Acute mesenteric venous thrombosis and focal segmental ischemia caused by strangulation of the small intestine or by localized venous thrombosis comprise the venous forms of AMI. [intechopen.com]
However, mesenteric arterial thrombosis producing massive gangrene of the bowel as content in inguinal hernia is an entity probably not reported in the medical literature. [pubmed.ncbi.nlm.nih.gov]
“Hypercoagulopathy (when blood forms a clot when it shouldn’t ) increases the chances of pulmonary embolism, deep vein thrombosis (DVT) and also mesenteric artery thrombosis.” Diagnosis Early detection is crucial. [indianexpress.com]
Doctors have also come across conditions wherein a thrombosis develops in intestinal veins leading to gangrene in the intestine. “There are many cases of pancreatitis as well as cholecystitis which doctors in Surat have treated. [timesofindia.indiatimes.com]
- Palpitations
For vital signs, fever was defined as a body temperature >38°C according to an ear thermometer; severe dehydration was defined as palpitation or hypotension according to the advanced paediatric life support guidelines and accepted fluid challenge. [journals.lww.com]
Workup
In most cases, patients undergo an extensive workup for obscure chronic abdominal pain before the patient is seen by a vascular surgeon. 3.2. [intechopen.com]
Serum
- Hyponatremia
In univariate analysis, nonbilious vomiting, peritoneal signs, severe dehydration, leukocytosis (WBC count >18,000 cells/mm3), elevated CRP (>50 mg/L), and hyponatremia (Na <130 mEq/L) were significantly associated with bowel gangrene. [journals.lww.com]
- Hyperglycemia
The stress response to critical illness may result in hyperglycemia and tissue infarction; SBV induces severe hypoperfusion and inflammation, leading to significant leukocytosis and elevated CRP, BUN, and creatinine. [journals.lww.com]
Microbiology
- Clostridium Perfringens
Bacteria such as clostridium perfringens, which produce toxic gases that can bubble up under the skin, are often implicated. [giantmicrobes.com]
Laboratory
- Leukocytosis
In infants with pneumoperitoneum, the presence of cloudy fluid with leukocytosis was indicative of gastrointestinal perforation. Using these two criteria, the accuracy of paracentesis in predicting the need for operation was 90%. [jamanetwork.com]
Patients with bowel gangrene showed marked differences in leukocytosis, glucose, CRP, sodium, and BUN compared with the nongangrenous-bowel group (P < 0.05) (Table 3). [journals.lww.com]
The common laboratory abnormalities are hemoconcentration, leukocytosis, metabolic acidosis, with high anion gap and increased lactate concentrations. [intechopen.com]
Treatment
Treatment “Blood thinners are the main treatment for this condition in early stages. If you have a blood clotting disorder, you may need to take blood thinners indefinitely. [indianexpress.com]
Treatment The goal of therapy for chronic mesenteric ischemia is revascularization. [intechopen.com]
The patient spent 2 days in ICU and 6 days in the surgical ward for follow-up and conservative treatment of ileus and wound infection with regular dressing and intravenous antibiotics as results of antimicrobial susceptibility test. [onlinelibrary.wiley.com]
The morbidity and mortality rates rise in parallel with delays in diagnosis and treatment (5). Early diagnosis and treatment are necessary to avoid life-threatening complications and to achieve good outcomes (4,6). [journals.lww.com]
Prognosis
Recurrence is not uncommon, and it carries a poor prognosis. [intechopen.com]
The presence of lymph node metastases had no influence on prognosis (P = 0.155). [scienceopen.com]
We reviewed the presentation, diagnosis, surgical treatment and prognosis of internal mesenteric hernia. 2 CASE PRESENTATION A 25-year-old male patient presented to the emergency department of our hospital with a 3-day history of sudden severe generalized [onlinelibrary.wiley.com]
Etiology
The most common etiology for SBV was malrotation in our series, whereas idiopathic etiologies (13–16) or worm mass (5) were the most common etiologies in previous studies. [journals.lww.com]
Etiological factors The etiology of acute mesenteric ischemia can be categorized into four specific types based on the cause of reduction of blood flow. 2.3. [intechopen.com]
Pathophysiology
With better understanding of the clinical syndromes and the pathophysiological basis of AMI a multidisciplinary approach in management has emerged for patients with suspected mesenteric vascular disease. [intechopen.com]
Prevention
The aim is initial resuscitation, prevention of further propagation of block, prevention of reperfusion injury and early restoration of blood flow. Underlying cause, if any, should also be simultaneously treated. [intechopen.com]
Other treatment modules: * Low-Molecular-Weight Heparin (LMWH) * Intravascular thrombolysis * In some cases, where intestinal gangrene has already established, surgical intervention Prevention Covid vaccines are supposed to trigger an immune response [indianexpress.com]
Intravenous antibiotics are often required, as is surgery to remove infected areas and prevent spreading. So keep an eye out for warning signs such as persistent pain, numbness, swelling, or strangely discolored skin. [giantmicrobes.com]
Most reports show that SPG carries a high mortality and morbidity rate, as no particular therapeutic option has been shown to consistently prevent the progression of the gangrene [10, 11]. [hindawi.com]