Difficulties in the Radiation Diagnosis of Acute Mesenteric Thrombosis in Patients with Chronic Critical Illness
https://doi.org/10.20862/0042-4676-2021-102-4-217-226
Abstract
Acute mesenteric ischemia is an acute disruption of blood supply to part of the intestine, which, if untreated, leads to bowel wall necrosis and a patient’s death. Computed tomography (CT) plays a leading role in detecting mesenteric ischemia and in making the initial diagnosis, especially in patients with chronic critical illness, when productive contact is impossible. The final diagnosis is established during surgery or postmortem examination. Timely diagnosis and surgical treatment are a basic tool to reduce high mortality rates from this disease. The article presents the possibilities of CT in imaging and making the primary diagnosis of mesenteric ischemia and mesenteric thrombosis.
About the Authors
O. A. StaroseltsevaRussian Federation
Olga A. Staroseltseva, Cand. Med. Sc., Radiologist, Radiation Diagnostics Division, Clinical and Diagnostic Department, Research Institute for Rehabilitation
Lytkino, 777, Solnechnogorskiy District, Moscow Region, 141534
N. V. Nudnov
Russian Federation
Nikolay V. Nudnov, Dr. Med. Sc., Professor, Deputy Director for Research
ul. Profsoyuznaya, 86, Moscow, 117997
M. L. Radutnaya
Russian Federation
Margarita L. Radutnaya, Head of Radiation Diagnostics Division, Clinical and Diagnostic Department, Research Institute for Rehabilitation
Lytkino, 777, Solnechnogorskiy District, Moscow Region, 141534
A. N. Kirchin
Russian Federation
Aleksandr N. Kirchin, Radiologist, Radiation Diagnostics Division, Clinical and Diagnostic Department, Research Institute for Rehabilitation
Lytkino, 777, Solnechnogorskiy District, Moscow Region, 141534
Е. А. Bondar’
Russian Federation
Еkaterina А. Bondar’, Radiologist, Radiation Diagnostics Division, Clinical and Diagnostic Department, Research Institute for Rehabilitation
Lytkino, 777, Solnechnogorskiy District, Moscow Region, 141534
L. V. Bessonova
Russian Federation
Liliya V.Bessonova, Radiologist, Radiation Diagnostics Division, Clinical and Diagnostic Department, Research Institute for Rehabilitation
Lytkino, 777, Solnechnogorskiy District, Moscow Region, 141534
E. L. Altukhov
Russian Federation
Evgeniy L. Altukhov, Surgeon, Surgical Department with Outpatient Clinic
Lytkino, 777, Solnechnogorskiy District, Moscow Region, 141534
A. A. Yakovlev
Russian Federation
Aleksey A. Yakovlev, Deputy Head of Research Institute for Rehabilitation
Lytkino, 777, Solnechnogorskiy District, Moscow Region, 141534
A. F. Shaybak
Russian Federation
Aleksandr F. Shaybak, Endoscopist, Head of Surgical Department with Outpatient Clinic
Lytkino, 777, Solnechnogorskiy District, Moscow Region, 141534
References
1. Daviaud F, Grimaldi D, Dechartres A, et al. Timing and causes of death in septic shock. Ann Intensive Care. 2015; 5(1): 16. https://doi.org/10.1186/s13613-015-0058-8.
2. Guillaume A, Pili-Floury S, Chocron S, et al. Acute mesenteric ischemia among post-cardiac surgery patients presenting with multiple organ failure. Shock. 2017; 47(3): 296–302. https://doi.org/10.1097/SHK.0000000000000720.
3. Acosta S. Mesenteric ischemia. Curr Opin Crit Care. 2015; 21(2): 171–8. https://doi.org/10.1097/MCC.0000000000000189.
4. Clair DG, Beach JM. Mesenteric Ischemia. N Engl J Med. 2016; 374(10): 959–68. https://doi.org/10.1056/NEJMra1503884.
5. Bala M, Kashuk J, Moore EE, et al. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2017; 12: 38. https://doi.org/10.1186/s13017-017-0150-5.
6. Кärkkäinen JM, Acosta S. Acute mesenteric ischemia (part I) – Incidence, etiologies, and how to improve early diagnosis. Best Pract Res Clin Gastroenterol. 2017; 31(1): 15–25. https://doi.org/10.1016/j.bpg.2016.10.018.
7. Moore HB, Moore EE, Lawson PJ, et al. Fibrinolysis shutdown phenotype masks changes in rodent coagulation in tissue injury versus hemorrhagic shock. Surgery. 2015; 158(2): 386–92. https://doi.org/10.1016/j.surg.2015.04.008.
8. Oliva IB, Davarpanah AH, Rybicki FJ, et al. ACR Appropriateness Criteria® imaging of mesenteric ischemia. Abdom Imaging. 2013; 38(4): 714–9. https://doi.org/10.1007/s00261-012-9975-2.
9. Shetty AS, Mellnick VM, Raptis C, et al. Limited utility of MRA for acute bowel ischemia after portal venous phase CT. Abdom Imaging. 2015; 40(8): 3020–8. https://doi.org/10.1007/s00261-015-0492-y.
10. Olson MC, Fletcher JG, Nagpal P, et al. Mesenteric ischemia: what the radiologist needs to know. Cardiovasc Diagn Ther. 2019; (9 Suppl 1): S74–87. https://doi.org/10.21037/cdt.2018.09.06.
11. Furukawa A, Kanasaki S, Kono N, et al. CT diagnosis of acute mesenteric ischemia from various causes. AJR Am J Roentgenol. 2009; 192(2): 408–16. https://doi.org/10.2214/AJR.08.1138.
Review
For citations:
Staroseltseva O.A., Nudnov N.V., Radutnaya M.L., Kirchin A.N., Bondar’ Е.А., Bessonova L.V., Altukhov E.L., Yakovlev A.A., Shaybak A.F. Difficulties in the Radiation Diagnosis of Acute Mesenteric Thrombosis in Patients with Chronic Critical Illness. Journal of radiology and nuclear medicine. 2021;102(4):217-226. (In Russ.) https://doi.org/10.20862/0042-4676-2021-102-4-217-226