| 1. |
- Acosta, Stefan, et al.
(författare)
-
Epidemiology and Prognostic Factors in Acute Superior Mesenteric Artery Occlusion.
- 2010
-
Ingår i: Journal of Gastrointestinal Surgery. - : Springer Science and Business Media LLC. - 1873-4626 .- 1091-255X. ; 14, s. 628-635
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Reports on trends in incidence and mortality of acute superior mesenteric artery (SMA) occlusion and evaluation of prognostic factors in recent years are lacking. METHODS: Patients with acute SMA occlusion were identified through the in-patient and autopsy registry between 1970 and 1982 (n = 270), 1987 to 1996 (n = 135), and 2000 and 2006 (n = 100) in Malmö, Sweden. RESULTS: The overall incidence rate decreased from 8.6 to 5.4/100,000 person years and the autopsy rate from 87% to 25% over time. A higher serum creatinine level was associated with a lower probability of undergoing multi-detector row computed tomography with intravenous contrast (MDCTiv) (p = 0.006). Not performing a MDCTiv (odds ratio 4.0; 95% confidence interval [1.0-16.0]) remained as independent prognostic factor for in-hospital mortality. General and vascular surgeons collaborated in 25 out of 61 patients that underwent an intervention, of which 21 (84%) (p < 0.001) survived. CONCLUSIONS: A close collaboration between radiologists and general and vascular surgeons seems to be most important to lower the mortality in patients with acute SMA occlusion.
|
|
| 2. |
- Olofsson, Fredrik, et al.
(författare)
-
No benefit of extended mesenteric resection with central vascular ligation in right-sided colon cancer.
- 2016
-
Ingår i: Colorectal Disease. - : Wiley. - 1462-8910.
-
Tidskriftsartikel (refereegranskat)abstract
- The optimal extent of mesenteric resection in colon cancer surgery is not known. We have previously shown an increased mortality associated with wider mesenteric resection in right hemicolectomy. This study compares the short and long-term outcome in three variations of right hemicolectomy based on the position of the vascular ligature in the mesentery.
|
|
| 3. |
- Olofsson, Fredrik, et al.
(författare)
-
Wide Excision In Right-Sided Colon Cancer Is Associated With Decreased Survival.
- 2013
-
Ingår i: Scandinavian Journal of Surgery. - : SAGE Publications. - 1799-7267 .- 1457-4969. ; 102:4, s. 241-245
-
Tidskriftsartikel (refereegranskat)abstract
- Nodal involvement is the most important prognostic factor in colon cancer. Although theoretically appealing, it is not known if wider mesenteric excision improves the oncological result. The aim of this retrospective study was to investigate whether wider mesenteric excision yields a superior oncological result.
|
|
| 4. |
- Wadman, Maria, et al.
(författare)
-
Abdominal plain film findings in acute ischemic bowel disease differ with age.
- 2006
-
Ingår i: Acta Radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 47:3, s. 238-243
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the use and findings of abdominal plain film in acute ischemic bowel disease (AIBD) in different age subsets, and to correlate the clinical findings. Material and Methods: Eighty-nine radiographically examined patients with AIBD at Malmö University Hospital, Sweden between 1987 and 1996. Results: In 89%, the plain film displayed pathologic signs. Bowel dilatation was more common in the elderly. Of 68 patients aged ⩾71 years, 19 (28%) had colon gas/fluid levels with/without colon dilatation, and of 19 patients >84 years 16 (84%) had small-bowel dilatation. Of 20 patients aged <71 years, 1 (5%) had colon gas/fluid levels with/without colon dilatation, and 11 (55%) small-bowel dilatation ( P<0.05; P<0.05). Gasless abdomen was more common in the younger age group, noted in 5 of 20 (25%) patients aged <71 years, compared to 2 of 68 (3%) patients aged ⩾71 years ( P = 0.001). Of the patients with diarrhea, 13 of 33 (40%) had colon gas/fluid levels with/without colon dilatation compared to 2 of 29 (7%) without ( P = 0.003). In the elderly (⩾71years), 48 of 53 (91%) patients with bowel dilatation on plain film died, compared to 11 out of 16 (69%) without this finding ( P<0.05). Conclusion: Abdominal plain film findings differed with age. Bowel dilatation was more frequent in the elderly with AIBD, whereas gasless abdomen was more common in younger patients. The radiographic findings were associated with clinical symptoms and mortality.
|
|
| 5. |
- Wadman, Maria, et al.
(författare)
-
Impact of MDCT with intravenous contrast on the survival in patients with acute superior mesenteric artery occlusion
- 2010
-
Ingår i: Emergency Radiology. - : Springer Science and Business Media LLC. - 1070-3004 .- 1438-1435. ; 17:3, s. 171-178
-
Tidskriftsartikel (refereegranskat)abstract
- Acute thromboembolic occlusion in the superior mesenteric artery (SMA) is a condition with high mortality and morbidity. Multi-detector computerised tomography with intravenous contrast enhancement (MDCTiv) may improve diagnostic accuracy and survival. Patients with acute SMA occlusion were identified between 2004 and 2008 at Malmö University Hospital, Sweden. Medical records were analysed. Each MDCTiv was re-evaluated. A total of 67 patients were identified with SMA occlusion, of which 36 were examined with MDCTiv and ten with plain MDCT without intravenous contrast. In all, 24 (67%) of the 36 patients were correctly diagnosed by MDCTiv at first evaluation. Clinical suspicion of intestinal ischemia followed by a distinct inquiry for intestinal ischemia was associated with trend for a higher rate of correct radiological diagnosis, 18 of 23 (78%), at first evaluation (0.06) but without affecting in-hospital survival (p = 0.27). At re-evaluation, SMA occlusion was found in all cases with MDCTiv, whereas intestinal findings were present in half. In-hospital mortality rate was 42% for patients who underwent MDCTiv, which was significantly lower compared to 90% for the ten patients examined with plain MDCT (p = 0.007) and 71% for patients not examined with MDCTiv or plain MDCT (p = 0.031). Patients that underwent plain MDCT had higher levels of creatinine compared to those examined with MDCTiv (p = 0.005). Patients who underwent intestinal revascularisation, endovascular or open, had higher survival rate (p = 0.001). Examination with MDCTiv in patients with acute SMA occlusion was associated with survival benefit. Hence, MDCTiv seems to be the method of choice in the workup phase. Radiologists should routinely describe the mesenteric vessels in patients with acute abdomen even when the diagnosis is not asked for. Patients with high creatinine levels are at risk to be examined without intravenous contrast, and survival in these patients is poor.
|
|
| 6. |
|
|
