Search PubMed⌕ Search
Home/Archive/PubMed

PubMed · 17060239

Mesenteric duplex scanning.

Erica L Mitchell·Gregory L Moneta
View original source ↗Export metadata ↓

Abstract

Duplex scanning of mesenteric arteries was developed in the late 1980s. It's primary clinical application is to identify high-grade stenoses in the superior mesenteric artery (SMA) and celiac artery that may be associated with the clinical condition of chronic mesenteric ischemia. A peak systolic velocity of >275 cm/s in the SMA identifies a >70% SMA stenosis with a sensitivity of 92%, a positive predictive value of 80% and a negative predictive value of 99%. A negative mesenteric duplex study therefore virtually excludes the presence of clinically important mesenteric artery stenosis. A positive study requires confirmation with an additional imaging study prior to mesenteric artery reconstruction. Other applications of mesenteric duplex scanning include identification of reversible compression of the celiac artery, follow-up of mesenteric bypass grafts and physiological studies of the intestinal circulation.

Explore related subjects

Celiac ArteryConstriction, PathologicFastingHumansIntestinesIschemiaMesenteric Artery, SuperiorMesenteric Vascular OcclusionPostprandial PeriodPractice Guidelines as TopicPredictive Value of TestsSplanchnic CirculationTomography, X-Ray ComputedUltrasonography, Doppler, DuplexJournal ArticleReview

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Erica L Mitchell, Gregory L Moneta. 2006. Mesenteric duplex scanning.. https://doi.org/10.1177/1531003506291885

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2005

Lessons learned in the management of thirteen celiac axis injuries.

OBJECTIVES: Celiac axis injuries are rare. The purposes of this study were to (1) review institutional experience, (2) determine additive effect on death of associated vessel injuries, and (3) correlate mortality rates with the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) for abdominal vascular injury. METHODS: This was a retrospective, 132-month study (January 1992 to December 2002) of patients with celiac axis injuries. RESULTS: Thirteen patients were included in the study. Mean revised trauma score was 5.35+/-2.63; mean injury severity score was 25+/-12. The mechanism was penetrating in 12 (92%) and blunt in 1 (8%); 3 of 13 had Emergency Department thoracotomy (100% mortality rate). Treatment included ligation in 11 and primary repair in 1; 1 exsanguinated. Overall survival was 5 of 13 (38%). Adjusted survival excluding patients who had Emergency Department thoracotomy was 5 of 10 patients (50%). Those surviving with isolated injuries included 57% of patients. Mortality rate versus AAST-OIS was grade III, 43% (3 of 7 patients); grade IV, 50% (1 of 2 patients); and grade V, 100% (4 of 4 patients). CONCLUSIONS: Celiac axis injuries are rare. Patients with isolated injuries have better survival rates. Mortality rate correlates well with AAST-OIS for abdominal vascular injury.

Celiac Artery↗
PubMed2004

Clinical approach to chronic gastrointestinal ischaemia: from 'intestinal angina' to the spectrum of chronic splanchnic disease.

Stenotic disorders of the splanchnic arteries are not rare, and it is generally assumed that symptoms are rare in patients with a single splanchnic stenosis, and even in patients with multiple-vessel stenoses. Currently, only gastric exercise tonometry aids the diagnostic evaluation, as it indicates actual ischaemia. Patients with stenotic disorders without complaints are referred to as having chronic splanchnic disease (CSD) and those with ischaemic complaints as having chronic splanchnic syndrome (CSS). The classical presentation of CSS, including the triad postprandial pain, weight loss and upper abdominal bruit, is also known as 'intestinal angina'. From the experience of our multidisciplinary working team on gastrointestinal ischaemia in 110 patients with stenoses of at least one splanchnic artery, two different clinical patterns were observed. In our series approximately 60% of patients with single-vessel stenoses, including the coeliac artery compression syndrome, have CSS. They have fewer complications, very low mortality, but most can be successfully treated by stenting or surgical treatment. Patients with multivessel splanchnic stenoses have more classical ischaemic complaints. Progression to a bowel infarction was seen in 34%, and mortality was 21%, mostly from bowel or myocardial infarction. Treatment should be tailored based upon perioperative risk assessment and local vascular anatomy. This may consist of autologous arterial bypass of one or two vessels, preferably antegrade. stenting or a combination of both. This differentiation between single- and multivessel splanchnic disease has considerable consequences for optimal work-up and treatment.

Celiac Artery↗