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Acute occlusive mesenteric ischemia in high altitude of southwestern region of Saudi Arabia.

Abstract

BACKGROUND AND OBJECTIVES
Mesenteric ischemia which can be acute or chronic depending on the rapidity of compromised blood flow produces bowel ischemia, infarction, bacterial transmigration, endotoxemia, multisystem organ failure and death. High altitude can precipitate thrombosis because of hypobaric hypoxia and its effect on coagulation system. The objectives of this study are to determine the risk factors, clinical presentation, type and pattern of acute occlusive mesenteric ischemia in high-altitude of southwestern region of Saudi Arabia.
MATERIALS AND METHODS
We reviewed the records of all the patients with acute occlusive mesenteric ischemia admitted to the Armed Forces Hospital, southern region, Kingdom of Saudi Arabia during the period of 2005 to 2010, and compiled data including demographics, clinical presentation, risk factors, preoperative investigations, management, histopathological examination, and complications. The cases of mesenteric ischemia resulting from conditions such as volvulus and strangulated hernias were excluded.
RESULTS
Our study included 21 patients, 10 (48%) men and 11 (52%) women with a mean age of 56 years (SD 14). Abdominal pain was the most common presenting symptoms. CT angiography depicted occlusive arterial disease in 8 patients (38%) and venous thrombosis in 13 patients (62%). Diabetes mellitus was the most frequent risk factor for arterial mesenteric ischemia. Chronic liver disease particularly liver cirrhosis was the most prominent risk factor for venous mesenteric thrombosis. Intestinal ischemia was confirmed by histopathological examination.
CONCLUSION
Acute occlusive mesenteric ischemia can mimic other more common intra-abdominal diseases clinically; therefore a high index of suspicion is required particularly for patients with relevant risk factors to prompt early diagnosis and intervention. Venous mesenteric thrombosis was more common than arterial mesenteric ischemia in our region.

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  • FREE Publisher Full Text
  • Authors

    Al-Shraim MM, Zafer MH, Rahman GA

    Source

    Annals of African medicine 11:1 pg 5-10

    MeSH

    Abdominal Pain
    Acute Disease
    Adult
    Aged
    Altitude
    Altitude Sickness
    Angiography
    Diabetes Complications
    Female
    Humans
    Intestines
    Ischemia
    Liver Cirrhosis
    Male
    Mesenteric Arteries
    Mesenteric Vascular Occlusion
    Mesenteric Veins
    Middle Aged
    Retrospective Studies
    Risk Factors
    Saudi Arabia
    Splanchnic Circulation
    Tomography, X-Ray Computed
    Venous Thrombosis

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22199040