Mesenteric Ischaemia | Acute Mesenteric Ischaemia скачать в хорошем качестве

Mesenteric Ischaemia | Acute Mesenteric Ischaemia

In this General Surgery lecture on mesenteric ischaemia, we aim to provide a comprehensive overview of the condition, focusing on its pathophysiology, clinical presentation, diagnostic approaches, and the various treatment options available, particularly emphasizing surgical interventions. ▬ 📌 Mesenteric Ischaemia Mesenteric ischaemia is a serious medical condition characterized by the reduction or cessation of blood flow to the mesentery, the tissue that connects the intestines to the abdominal wall. This insufficient blood supply can lead to bowel tissue damage and, in severe cases, life-threatening complications such as gangrene or sepsis. Mesenteric ischaemia can be classified into two main types: acute and chronic. Acute mesenteric ischaemia (AMI) is a rapidly progressing condition that warrants immediate medical attention. ▬ 📌 Acute Mesenteric Ischaemia AMI is a critical emergency that usually develops suddenly, often as a result of an arterial blockage, blood clot, or decreased blood flow to the mesentery. This reduced blood flow leads to tissue ischemia and, if left untreated, can result in bowel infarction, necrosis, and systemic infection. The most common cause of AMI is an embolism or thrombosis in the superior mesenteric artery, which supplies blood to the small intestine. ▬ 📌 Mesenteric Ischaemia Diagnosis Diagnosing AMI can be challenging due to its nonspecific symptoms, which may include sudden, severe abdominal pain, nausea, vomiting, diarrhoea, and bloating. Early diagnosis is crucial for successful treatment and recovery. Diagnostic tests include blood tests to assess inflammation and organ function, CT scans or angiography to visualize the affected vessels, and in some cases, exploratory laparotomy to assess the extent of bowel damage. ▬ 📌 Mesenteric Ischaemia Treatment The primary goal of AMI treatment is to restore blood flow to the affected bowel tissue and remove any damaged or necrotic tissue. Initial management includes supportive measures, such as fluid resuscitation, analgesia, and antibiotics to prevent or treat infection. ▬ 📌 Surgical Treatment Surgical treatment is often the mainstay of therapy for acute mesenteric ischaemia (AMI) to address the underlying cause of the reduced blood flow to the bowel and to remove any damaged or necrotic tissue. The choice of surgical intervention depends on the cause and extent of the ischaemia. The most common surgical procedures include: 👉 Embolectomy This procedure involves the removal of an embolus (a blood clot or other foreign material) that is blocking the blood flow in the mesenteric artery. The surgeon makes an incision in the artery and uses specialized instruments to extract the embolus, thereby restoring blood flow to the affected bowel. 👉 Thrombectomy Similar to embolectomy, thrombectomy focuses on removing a blood clot (thrombus) that has formed within the artery, leading to reduced blood flow. The surgeon may employ various techniques, such as using a catheter to suction out the clot or employing a clot-dissolving medication to break it down. 👉 Bypass surgery In cases where the blood vessel is severely narrowed or blocked, bypass surgery may be performed. This procedure involves creating a new pathway for blood flow using a graft, which can be a synthetic material or a segment of the patient's own blood vessel. The graft is connected above and below the blocked or narrowed section of the artery, allowing blood to flow around the obstruction and reach the bowel. 👉 Bowel resection and anastomosis If the ischaemia has resulted in bowel tissue death (necrosis), the surgeon must remove the affected segment of the intestine. After removing the necrotic tissue, the healthy ends of the bowel are reconnected through a procedure called anastomosis. In some cases, if the bowel cannot be reconnected immediately, a temporary colostomy or ileostomy may be created to allow waste to exit the body. 👉 Bowel reconstruction In more complex cases, such as when a significant portion of the bowel has been removed or the blood supply is severely compromised, a bowel reconstruction may be necessary. This procedure involves reconnecting the remaining bowel segments in a manner that optimizes function and blood flow. ▬ 📌 Post-Revascularization Considerations After successful revascularization, patients require close monitoring to ensure adequate blood flow to the bowel and to detect any potential complications. Ongoing supportive care, including pain management, nutritional support, and antibiotic therapy, is essential for optimal recovery. Rehabilitation and follow-up care may involve lifestyle modifications, such as dietary changes, smoking cessation, and exercise, to reduce the risk of recurrent mesenteric ischaemia. ▬ 🎬 5500+ sqadia.com Medical Videos ▬▬▬▬▬▬▬▬▬▬ 👩🏻‍⚕️ Accessible Medical Student Education 24/7/365 💡 Simplifying Medical Learning 💪 Study Hard, Dream Big, Achieve More