Clinical management of chronic mesenteric ischemia

被引:41
作者
van Dijk, Louisa J. D. [1 ,2 ,14 ]
van Noord, Desiree [1 ,3 ,21 ]
de Vries, Annemarie C. [1 ]
Kolkman, Jeroen J. [4 ,5 ,11 ]
Geelkerken, Robert H. [6 ,7 ,11 ]
Verhagen, Hence J. M. [8 ,14 ]
Moelker, Adriaan [2 ,14 ]
Bruno, Marco J. [1 ,12 ]
Balm, Ron [9 ]
de Borst, Gert Jan [10 ]
Blauw, Juliette T. [11 ]
Bakker, Olaf J. [13 ]
Buscher, Hessel C. J. L. [15 ]
Fioole, Bram [16 ]
Hamming, Jaap F. [17 ]
Harki, Jihan [14 ,17 ]
van den Heuvel, Daniel A. F. [13 ]
van Hattum, Eline S. [10 ]
Hinnen, Jan Willem [18 ]
van der Laan, Maarten J. [19 ]
Lenaerts, Kaatje [20 ]
Peppelenbosch, Maikel P. [14 ]
van Petersen, Andre S. [22 ]
Rijnja, Pepijn [11 ]
van der Schaar, Peter J. [23 ]
Terlouw, Luke G. [14 ]
de Vries, Jean Paul P. M. [19 ]
Vroegindeweij, Dammis [24 ]
机构
[1] Erasmus MC, Univ Med Ctr, Dept Gastroenterol & Hepatol, Rotterdam, Netherlands
[2] Erasmus MC, Univ Med Ctr, Dept Radiol, S Gravendijkwal 230, Rotterdam, Netherlands
[3] Franciscus Gasthuis & Vlietland, Dept Gastroenterol & Hepatol, Rotterdam, Netherlands
[4] Medisch Spectrum Twente, Dept Gastroenterol & Hepatol, Enschede, Netherlands
[5] Univ Med Ctr Groningen, Dept Gastroenterol & Hepatol, Groningen, Netherlands
[6] Medisch Spectrum Twente, Dept Vasc Surg, Enschede, Netherlands
[7] Univ Twente, Fac Sci & Technol, Tech Med Ctr, Enschede, Netherlands
[8] Erasmus MC, Univ Med Ctr, Dept Vasc Surg, Rotterdam, Netherlands
[9] Acad Med Ctr, Amsterdam, Netherlands
[10] Univ Med Ctr Utrecht, Utrecht, Netherlands
[11] Med Spectrum Twente, Enschede, Netherlands
[12] Erasmus MC, Univ Med Ctr, Rotterdam, Netherlands
[13] St Antonius Hosp, Nieuwegein, Netherlands
[14] Erasmus MC, Univ Med Ctr, Rotterdam, Netherlands
[15] Gelre Hosp, Apeldoorn, Netherlands
[16] Maasstad Hosp, Rotterdam, Netherlands
[17] Leiden Univ, Med Ctr, Leiden, Netherlands
[18] Jeroen Bosch Hosp, Shertogenbosch, Netherlands
[19] Univ Med Ctr Groningen, Groningen, Netherlands
[20] Maastricht Univ, Med Ctr, Maastricht, Netherlands
[21] Franciscus Gasthuis & Vlietland, Rotterdam, Netherlands
[22] Bernhoven Hosp, Uden, Netherlands
[23] St Antonius Hosp, Nieuwegein, Netherlands
[24] Maasstad Hosp, Rotterdam, Netherlands
关键词
Chronic mesenteric ischemia; atherosclerosis; median arcuate ligament syndrome; computed tomography angiography; endovascular therapy; GASTRIC EXERCISE TONOMETRY; VISIBLE-LIGHT SPECTROSCOPY; ARTERY; REVASCULARIZATION; MORTALITY; DIAGNOSIS; STENOSIS;
D O I
10.1177/2050640618817698
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
This review provides an overview on the clinical management of chronic mesenteric ischemia (CMI). CMI is defined as insufficient blood supply to the gastrointestinal tract, most often caused by atherosclerotic stenosis of one or more mesenteric arteries. Patients classically present with postprandial abdominal pain and weight loss. However, patients may present with, atypically, symptoms such as abdominal discomfort, nausea, vomiting, diarrhea or constipation. Early consideration and diagnosis of CMI is important to timely treat, to improve quality of life and to prevent acute-on-chronic mesenteric ischemia. The diagnosis of CMI is based on the triad of clinical symptoms, radiological evaluation of the mesenteric vasculature and if available, functional assessment of mucosal ischemia. Multidisciplinary consensus on the diagnosis of CMI is of paramount importance to adequately select patients for treatment. Patients with a consensus diagnosis of single-vessel or multi-vessel atherosclerotic CMI are preferably treated with endovascular revascularization.
引用
收藏
页码:179 / 188
页数:10
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