Cases reported "Ischemia"

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1/367. Post-traumatic thrombosis of a segmental branch of the inferior mesenteric vein.

    We report the case of man with post-traumatic thrombosis in a segmental branch of the inferior mesenteric vein with secondary venous congestion and ischemia of the sigmoid colon. We discuss the current imaging modalities for diagnosing venous thrombosis and their relative significance.
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ranking = 1
keywords = thrombosis, venous thrombosis, vein
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2/367. sympathetic nervous system and pain: a clinical reappraisal.

    The target article discusses various aspects of the relationship between the sympathetic system and pain. To this end, the patients under study are divided into three groups. In the first group, called "reflex sympathetic dystrophy" (RSD), the syndrome can be characterized by a triad of autonomic, motor, and sensory symptoms, which occur in a distally generalized distribution. The pain is typically felt deeply and diffusely, has an orthostatic component, and is suppressed by the ischemia test. Under those circumstances, the pain is likely to respond to sympatholytic interventions. In a second group, called "sympathetically maintained pain" (SMP) syndrome, the principal symptoms are spontaneous pain, which is felt superficially and has no orthostatic component, and allodynia. These symptoms, typically confined to the zone of a lesioned nerve, may also be relieved by sympathetic blocks. Since the characteristics of the pain differ between RSD and SMP, the underlying kind of sympathetic-sensory coupling may also vary between these cases. A very small third group of patients exhibits symptoms of both RSD and SMP. The dependence or independence of pain on sympathetic function reported in most published studies seems to be questionable because the degree of technical success of the block remains uncertain. Therefore, pain should not be reported as sympathetic function independent until the criteria for a complete sympathetic block have been established and satisfied.
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ranking = 0.00013020881709603
keywords = deep
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3/367. Acute upper limb ischemia: a complication of coronary artery bypass grafting.

    We present the case of a patient with acute upper limb ischemia after radial artery harvest for coronary artery bypass grafting. This occurred despite adequate preoperative and intraoperative assessment with the Allen test, hand-held Doppler and radial artery backbleeding. A successful outcome was achieved by performing brachioradial bypass grafting using reversed cephalic vein.
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ranking = 0.0037609501160398
keywords = vein
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4/367. Implantable spinal cord stimulator to treat the ischemic manifestations of thromboangiitis obliterans (Buerger's disease).

    thromboangiitis obliterans (Buerger's disease) is a segmental inflammatory vasculitis that involves the small-sized and medium-sized arteries, veins, and nerves. It is causally related to tobacco use. The diagnosis is usually made on the basis of the presence of distal arterial disease in individuals who smoke and in whom other disease entities have been excluded. The most effective treatment for Buerger's disease is smoking cessation. Without strict adherence to tobacco avoidance, disease progression is likely. methods to control ischemic pain include medications, sympathectomy, or surgical revascularization. The effect of sympathectomy is unpredictable, and the chances of a successful revascularization procedure are rare because distal target vessels often are extensively diseased. Herein, we describe a patient whose condition did not respond to the usual conservative therapy but did respond dramatically to the implantation of a permanent spinal cord stimulator. Although these devices have been used for more than 20 years in various other peripheral arterial diseases, their use in Buerger's disease has been limited.
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ranking = 0.0037609501160398
keywords = vein
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5/367. The hemodynamics of steal syndrome and its treatment.

    A 61-year-old man developed steal syndrome after creation of a transposed basilic vein arteriovenous fistula (AVF) resulting in rest pain and ischemic ulcers in the fingertips. Our initial surgically created stenosis reduced the diameter by 32% and the area by 56%, and increased the radial artery pressure from 52 to 78 mmHg, with relief of symptoms. Within 3 weeks his symptoms reappeared. Repeat measurements did not explain his return of symptoms. A second area of stenosis was created in the AVF, with a diameter reduction of 75%, and an area reduction of 94%. His symptoms resolved, and his ulcers healed. The hemodynamics of the AVF and the steal syndrome were evaluated by duplex imaging and Doppler pressure assessment. A greater stenosis increased the radial artery pressure from 78 to 140 mmHg while maintaining flow through the AVF. Rather than increasing the degree of stenosis at the first site, we created a second area of stenosis. Hemodynamically, this would be additive to the first without the risk of creating a high-grade stenosis that could thrombose the AVF. Increasing the resistance in the AVF will decrease flow in the AVF and, ultimately, increase flow to the hand.
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ranking = 0.0037609501160398
keywords = vein
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6/367. Ischemic necrosis of bile ducts complicating Schonlein-Henoch purpura.

    Gastrointestinal complications of Schonlein-Henoch purpura are frequent and sometimes severe. However, there seem to be no reports of liver involvement. A child is described in whom Schonlein-Henoch purpura was complicated by bile duct lesions, resulting in biliary cirrhosis and requiring liver transplantation. At surgical removal, the liver had lesions of bile ducts and of adjacent small blood vessels in the hilum, very similar to those complicating hepatic artery thrombosis after liver transplantation. These findings suggest that Schonlein-Henoch purpura can be complicated by vasculitis of the peribiliary vessels resulting in ischemic necrosis of the bile ducts. Schonlein-Henoch purpura can be added to the list of causes of ischemic cholangiopathies.
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ranking = 0.16184076208351
keywords = thrombosis
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7/367. Oral contraceptive-induced mesenteric venous thrombosis with resultant intestinal ischemia.

    The author reports a case of oral contraceptive-induced mesenteric venous thrombosis with resultant intestinal ischemia in a young woman. The relationship between mesenteric venous thrombosis and oral contraceptives is discussed. Twenty-six other cases of oral contraceptive-related mesenteric venous thrombosis reported in the English literature are reviewed.
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ranking = 1.2039400730159
keywords = thrombosis, venous thrombosis
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8/367. Gastric intramucosal pH as a monitor of gut perfusion after thrombosis of the superior mesenteric vein.

    Gastric intramucosal pH (pHi) when measured by a tonometer is a simple and minimally invasive method to determine gut ischemia. In a case of severe mesenteric venous thrombosis, we measured pHi intra- and postoperatively over a period of five days. The goal was to monitor improvement or deterioration of gastrointestinal perfusion in the intensive care unit and to perform a second-look laparotomy if the condition worsened. We observed that gastric pHi is a more sensitive parameter for detecting intestinal ischemia than parameters such as arterial pH, base excess, or lactate. This patient's pHi rose continuously, which allowed us to proceed in a conservative way without any further invasive diagnostic interventions. Thus, the application of a gastric tonometer in cases of mesenteric venous thrombosis may help to reduce costs by preventing unnecessary postoperative diagnostic maneuvers such as angiography, computed tomography, or even second-look laparotomy.
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ranking = 1.0063897268027
keywords = thrombosis, venous thrombosis, vein
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9/367. Refractory proctosigmoiditis caused by myointimal hyperplasia of mesenteric veins: report of a case.

    PURPOSE: Proctosigmoiditis occurring in young adults is usually idiopathic and usually responds to medical management. If the process progresses to pancolitis and is refractory to medical management, proctocolectomy may be required. Myointimal hyperplasia of mesenteric veins, though rare, may also cause proctosigmoiditis, but this entity, in contrast to the idiopathic variety, does not respond to medical management; surgical excision limited to the involved colonic segment is curative. Because the treatment of the two entities differs significantly, it is important to distinguish them diagnostically. The purpose of this case report is to increase awareness of myointimal hyperplasia of mesenteric veins and to emphasize the clinical features that distinguish it from idiopathic proctosigmoiditis. methods: We report the case of a twenty-two-year-old male with an inflammatory process involving the distal colon and rectum, initially thought to be idiopathic proctosigmoiditis. The inflammation did not respond to an extensive course of medical management, and the patient developed complications associated with both the disease process and his medical therapy. Surgical resection of the rectosigmoid was performed. RESULTS: Histologic examination of the resected colon revealed the underlying process to be colonic ischemia caused by myointimal hyperplasia of mesenteric veins not associated with idiopathic inflammatory bowel disease or systemic vasculitis. CONCLUSION: Proctosigmoiditis caused by myointimal hyperplasia of mesenteric veins and idiopathic proctosigmoiditis may present in a similar fashion. Although patients with myointimal hyperplasia of mesenteric veins do not respond to medical management, segmental resection is usually curative, and long-term drug therapy or even proctocolectomy can be avoided. physicians should consider the possibility of myointimal hyperplasia of mesenteric veins when patients with apparent idiopathic proctosigmoiditis do not respond to medical therapy.
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ranking = 0.037609501160398
keywords = vein
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10/367. Congenital ischemic forearm necrosis associated with a compound presentation.

    An infant born in a compound presentation had ischemic forearm necrosis requiring amputation. Bilateral renal vein thrombosis predating labor and delivery was also diagnosed. The possibility of congenital ischemic necrosis in an extremity should not affect the obstetrical management of compound presentation, but if this complication occurs a search for an underlying coagulopathy is important.
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ranking = 0.16736055904845
keywords = thrombosis, vein, vein thrombosis
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