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Results for “Mesenteric Artery, Superior”

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At least 19 recordsLinked to original sources
PubMed1995

Enhanced contractile responses mediated by different 5-HT receptor subtypes in basilar arteries, superior mesenteric arteries and thoracic aortas from stroke-prone spontaneously hypertensive rats.

1. The contractile effects of 5-hydroxytryptamine (5-HT) in isolated ring preparations of basilar arteries (BA) thoracic aortas (TA) and superior mesenteric arteries (SMA) from stroke-prone spontaneously hypertensive rats (SHRSP) and Wistar-Kyoto (WKY) rats were investigated pharmacologically. 2. The pD2 values (expressed as a negative logarithm of of EC50) for 5-HT in BA of SHRSP were greater than those of WKY. Increased pD2 values for 5-HT were also found in SMA and TA of SHRSP when compared to WKY. 3. Ketanserin (a 5-HT2 antagonist) produced a biphasic displacement of the concentration-response curves for 5-HT in BA of WKY and SHRSP but elicited a parallel rightward shift of the 5-HT curve in SMA and TA of the two groups. 4. 5-CT (a 5-HT1 agonist)-induced contractions and their pD2 values in the presence of ketanserin were larger in BA of SHRSP than in those of WKY, while 5-CT did not contract SMA or TA in either group. 5. No significant difference was found in the contractile response induced by alpha-methyl-5-HT (a 5-HT2 agonist) in BA from SHRSP and WKY, while the pD2 values for alpha-methyl-5-HT were increased in SMA and TA from SHRSP when compared to WKY. 6. These results suggest that the hyperresponsiveness to 5-HT found in SHRSP arteries may be mediated by different 5-HT receptor subtypes, that is, by 5-HT1 in BA and by 5-HT2 in SMA and TA.

Animals↗
PubMed1991

Aneurysm arising from the branch of the superior mesenteric artery.

Superior mesenteric branch aneurysms are rare and usually become symptomatic at the time of rupture. Pain, gastrointestinal blood loss and intra-abdominal hemorrhage draw attention to the presence of aneurysms in 70% of the reported cases. We report on a 64-year-old male patient who had an emergent laparotomy for acute abdominal pain at a local hospital in Changhua in March of 1988. The operative finding was an unresectable mesentric mass, and the pathologic finding of the biopsy was a chronic abscess. Because of two episodes of tarry stools after the operation, the patient was referred to the National Taiwan University Hospital for further evaluation of the intra-abdominal mass. After admission in April of 1990, abdominal sonogram and CT examinations demonstrated the presence of a multilobulated mass which was suspected to be an aneurysm. Selective superior mesenteric arteriography confirmed this diagnosis and showed that the aneurysm arose from the origin of the ileocolic branch. At surgery, the aneurysm was found to have a fistula tract communicating with the terminal ileum. The aneurysm and the associated segment of the terminal ileum were successfully removed. We herein report this unusual case.

Aneurysm↗
PubMed1993

[Changes in the blood flow in celiac artery and superior mesenteric artery after stellate ganglion block].

We evaluated the effect of stellate ganglion block (SGB) on the blood flow of celiac artery (CA) and superior mesenteric artery (SMA) by using the ultrasonic pulse Doppler technique. The subjects were 15 healthy volunteers (14 males, one female; average 26 years old; 22-38). Right C7-SGB was performed using 5 ml of 1% mepivacaine at the 7th cervical process. Blood pressure, heart rate, mean blood flow velocity and diameter in CA and SMA, were measured after 5 minute rest, before and after SGB. To measure the flow velocity and the diameter of vessels, ultrasonic diagnostic equipment SSA-270A or SSA-260A (Thoshiba CO, Ltd.) with convex electric-phased 3.75 MHz, probe was used. Doppler shiftgrams of the CA and SMA were recorded. Then, we calculated their flow volume and sectional area of vessels. In CA mean blood flow velocity tended to decrease (P < 0.05) and both flow volume and sectional area of vessels tended to increase (P < 0.001). In SMA, mean flow velocity tended to decrease (P < 0.05) and sectional area increased (P < 0.001). But flow volume did not show significant change. Our results indicate that right C7-SGB leads to an increase in the blood flow of CA.

Adult↗
PubMed2001

Colonic necrosis subsequent to catheter-directed thrombin embolization of the inferior mesenteric artery via the superior mesenteric artery: a complication in the management of a type II endoleak.

The optimal management of endoleaks after endovascular repair of abdominal aortic aneurysms remains to be established. In this report, we describe a persistent side-branch, or type II, endoleak 1 year after endograft implantation treated with catheter-directed embolization of the aneurysm sac and the inferior mesenteric artery via the superior mesenteric artery, with embolization agents including thrombin, lipiodol, and gelfoam powder. Shortly after the embolization procedure, colonic necrosis developed in the patient, manifested by peritonitis, which necessitated a partial colectomy. This case underscores the devastating complication of colonic ischemia as a result of catheter-directed embolization of the inferior mesenteric artery in the management of an endoleak.

Aged↗
PubMedDate not supplied

Polysplenia syndrome with hepatic artery of superior mesenteric artery origin and a circumaortic renal vein.

An 8 1/2-month-old girl with biliary atresia and polysplenia syndrome having multiple vascular anomalies without cardiac anomalies is reported. Interruption of the inferior vena cava with azygous continuation, which is a common anomaly, was seen in conjunction with origin of the common hepatic artery from the superior mesenteric artery and with a circumaortic renal vein. The case has particular importance in that no hepatic artery or renal vein variations have been described with biliary atresia and polysplenia syndrome in the literature thus far to our knowledge. The anomalies were shown using different radiological examinations including computed tomography, echocardiography, angiography, venography and magnetic resonance imaging.

Abnormalities, Multiple↗
PubMedDate not supplied

Splenic artery-to-superior mesenteric artery bypass for chronic mesenteric ischemia--a case report.

Chronic mesenteric ischemia (CMI) is a serious vascular condition that if left untreated may progress to acute ischemia resulting in bowel necrosis and high surgical morbidity/mortality rates. Elective intervention has been shown to prevent this progression and relieve symptoms. Current open surgical intervention involves arterial bypass using a vein or synthetic graft conduit with the inflow originating from the aorta or iliac artery. In some circumstances, the splenic artery provides an additional treatment option for revascularization of the superior mesenteric artery. In certain cases, the splenic artery has several advantages over traditional surgical options. The splenic artery is an arterial conduit much like the internal mammary artery used in coronary artery bypass grafting. These grafts are known for their long-term patency and in selected clinical circumstances are preferred over venous grafts. Because the splenic artery has a natural inflow, only a single vascular anastomosis at the outflow vessel (the SMA) is necessary. This lessens the risk of anastomotic stenosis by decreasing the number of anastomoses created and it makes the procedure shorter in duration. The fact that the inflow is provided by the splenic artery makes cross-clamping of the aorta unnecessary, thereby lessening the risk of producing cardiac ischemia and declamping hypotension. A disadvantage is the risk of splenic ischemia with the possible need for splenectomy. The majority of individuals will have adequate collateral supply to the spleen via the short gastric arteries. The risk to the patient of splenectomy versus the benefits of a less complicated arterial reconstruction with avoidance of aortic cross-clamping must be weighed on a case-by-case basis. Preventing the progression to acute mesenteric ischemia with its increased mortality by timely restoration of adequate vascular supply is an important principle in treating patients with CMI. Controversy still exists over the best treatment option for these patients, whether it be antegrade versus retrograde bypass, single-vessel versus multivessel reconstruction, or open surgical repair versus endovascular intervention. In selected patients, the use of the splenic artery can be considered as an additional option for arterial reconstruction of the SMA.

Aged↗
PubMed2000

Embolization of type II endoleaks fed by the inferior mesenteric artery: using the superior mesenteric artery approach.

PURPOSE: To evaluate the use of a superior mesenteric artery (SMA) approach to embolize type II endoleaks arising from the inferior mesenteric artery (IMA). TECHNIQUE: When reperfusion of the aneurysmal sac via the SMA occurs through the IMA, as shown by computed tomography (CT) and angiography, the IMA origin can be accessed via the marginal artery or the anastomosis of Riolan. The SMA is catheterized with a 5-F catheter, and a coaxial catheter is advanced to the leak to deliver 2- to 8-mm-diameter minicoils to embolize the IMA origin and entire aneurysmal sac. Embolization usually requires from 1 to 2 hours to complete. In our experience with this technique in 11 cases, complications have not occurred, and there has been only one very small residual leak that sealed the next day. Over a 24.5-month follow-up (range 12-39), the endoleaks have remained sealed according to serial color duplex scans. CONCLUSIONS: Successful percutaneous treatment of type II endoleak due to IMA inflow can be accomplished using an SMA access via the Riolan anastomosis or marginal artery. The procedure appears to be safe and has no adverse effects.

Aged↗
PubMed1997

Ammonia determination as an early indicator in experimental superior mesenteric artery occlusion.

Superior mesenteric artery occlusion (SMAO) is often fatal. An indicator which enables the early diagnosis of SMAO is needed. As we think putrefaction products must appear and increase in the blood and ascites in SMAO, changes in the concentrations of ammonia, one of the putrefaction products, were measured in this study. Thirteen adult mongrel dogs were used for the in vitro experiment. The jejunum, ileum, and ascending colon were resected and incubated in saline. Changes in ammonia concentrations in the saline were examined at various incubation times. In the in vivo experiment, 11 mongrel dogs comprised the SMAO group and another 10 mongrel dogs comprised the control group. Changes in ammonia concentrations in the blood and ascites were examined in both groups. In the in vitro experiment, ammonia concentrations in the saline bath increased in all samples. It was highest in the sample from around the ascending colon, and lowest from around the jejunum. However, at the end of experiment, this difference became insignificant. In the in vivo experiment, ammonia concentrations in samples of the blood increased early and significantly in the SMAO group, compared with the control group. Ammonia concentrations in samples of the ascites also increased significantly. The in vitro experiment showed that ammonia leaked from the ischemic intestines, and secondarily, a large amount of ammonia was produced from intestinal putrefaction. The in vivo experiment revealed that the ammonia level in the blood could be used as a good early indicator of acute mesenteric ischemia.

Ammonia↗
PubMed1997

Superior mesenteric artery syndrome.

Superior mesenteric artery syndrome is a rare and controversial form of upper intestinal obstruction in which the third part of the duodenum is compressed by the overlying superior mesenteric artery. Any disease process decreasing the angle between the superior mesenteric artery and the abdominal aorta can result in the external compression of the duodenum and subsequent intestinal obstruction. The aetiology, presentation, investigation and management of this unusual condition are discussed.

Humans↗
PubMed1987

Rare case of the inferior mesenteric artery arising from the superior mesenteric artery.

The authors observed a variation of the inferior mesenteric artery, which arose from the superior mesenteric artery, in a 69-year-old Japanese male cadaver during dissection in 1984. In this case, no rudiment of the ordinary inferior mesenteric artery could be found on the abdominal aorta. There are few reports of this variation, and an extensive search of the available literature revealed only four cases, including two in Japan. Such a variation had been somewhat inadequately described as an "absence of the inferior mesenteric artery" in the previous reports, but we avoided this terminology, because all of the cases possessed an artery, which, though arising from the superior mesenteric artery instead of the abdominal aorta, had the same branches as a normal inferior mesenteric artery. Consistent with findings observed in the previous cases, the unusual inferior mesenteric artery arose as the first branch of the superior mesenteric artery, with the common trunk of both mesenteric arteries originating from the abdominal aorta at a level at which an ordinary superior mesenteric artery would arise. It is for this reason that we did not adopt another acceptable name, that is, "the common mesenteric artery," for this variation. The variation can be explained as the result of an unusual development of the embryonic artery system, which comprises a number of ventral splanchnic arteries interconnected by longitudinal anastomotic channels to supply the primitive digestive tube.

Aged↗
PubMed1996

Embolization for ruptured superior mesenteric artery aneurysms.

Superior mesenteric artery (SMA) aneurysms are very uncommon. They are difficult to detect until they rupture and cause hypovolaemic shock. We performed embolization in four cases of aneurysm of branches of the superior mesenteric artery, succeeding in three cases without the need for surgical treatment. In the first case, the aneurysm was excised because of migration of a microcoil into the left hepatic artery. It was not retrieved because sufficient blood flow to the liver was shown on angiography after migration and no ischaemic change of liver was detected on laparotomy. In the second case, the aneurysm arose from the anterior pancreaticoduodenal artery. In the third case, the patient had two SMA aneurysms; one had been resected at surgery, another was revealed on follow-up angiography and embolized with microcoils. The fourth patient had a jejunal artery aneurysm with extravasation; haemostasis was achieved by packing it. In all four cases, no major complications were observed in the clinical course after embolization. Microcoils were considered to be the desirable embolic material, in order to prevent post-therapeutic ischaemic change. Embolization should be the treatment of choice for SMA aneurysms, because it is less invasive and takes less time than surgical treatment.

Adult↗
PubMed2006

Endovascular repair of a thoracoabdominal aortic aneurysm involving the celiac artery and the superior mesenteric artery.

We present a successful endovascular repair of a thoracoabdominal aortic aneurysm (TAAA) involving the celiac artery and the superior mesenteric artery. After the intentional occlusion of the celiac artery, an Inoue stent graft with a side arm to the superior mesenteric artery was implanted. Management of the visceral arteries in the endovascular repair of TAAA was highlighted.

Aged↗
PubMedDate not supplied

Laparoscopic management of superior mesenteric artery syndrome.

Superior mesenteric artery syndrome (SMAS) is a rare clinical condition that should be considered in patients with long-standing abdominal complaints where endoscopic and conventional roentgenographical findings are often negative. It has been claimed that SMAS is caused by intermittent obstruction of the horizontal portion of the duodenum between the superior mesenteric artery and the spine and the aorta. The main target of this presentation is to present our experience in the laparoscopic management of 4 cases of documented SMAS after failure of medical treatment. The laparoscopic severing of the ligament of Treitz is a feasible and safe technique. It could bring about total relief of symptoms in three out of the four patients. The operative time rapidly decreased with the acquaintance of the field. The visualization (exposure) is quite satisfactory. the technique offers added precision and accuracy to the dissection manoeuvres. Recovery was uneventful and rapid with minimal needs for postoperative analgesia. We recommend the use of mini-endoshear (pediatric). Phases of dissection from the mesocolon and retro-pancreatically are presented. We stress the finding of the drainage of the inferior mesenteric vein into the superior mesenteric vein instead of the splenic vein. This could put the inferior mesenteric vein (looking as a fibrous band) in jeopardy. Also it reduces the area of access to the retropancreatic dissection. We raise the possibility of an etiological role of this anatomical variation to the duodenal compression and call upon the study of such a possibility. The importance to attain the proper retropancreatic space has been shown by the possibility of dissecting between the uncinate process and the rest of the pancreas. The psychological impact of a minimal invasive approach together with symptoms relief was quite rewarding.

Abdominal Pain↗
PubMed2006

Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome.

Superior mesenteric artery syndrome (Wilkie's syndrome) causes acute or chronic compression of the third part of the duodenum. Initially conservative treatment is tried, but on failure of treatment, duodenojejunostomy is the procedure of choice, usually done by open surgery. We present a case of superior mesenteric artery syndrome in which the duodenojejunostomy was done laparoscopically.

Dilatation, Pathologic↗
PubMed1987

[Observation of the superior mesenteric artery by ultrasonography: for prediction of the superior mesenteric artery syndrome].

Superior mesenteric artery (SMA) syndrome is a major complication after scoliosis surgery. The author reports an ultrasonic observation of the SMA in normal and scoliotic individuals. There are three patterns of the SMA anatomy: Type I in which the SMA runs very close and parallel to the aorta, Type II in which the SMA branches off the aorta at a certain angle and Type III in which the SMA runs parallel to the aorta. Dynamic observation revealed that passage of food displaces the SMA anteriorly and to the left and that turning to the left from a supine position displaces the SMA from just anterior to the left of the aorta in normal individuals and from the right to the left side of the aorta in scoliosis cases. AMA itself has no significance in the occurrence of SMA syndrome because the SMA moves rather freely with the passage of food or position change. When this natural movement of the SMA is disturbed, one should carefully look for the possibility of SMA syndrome.

Adolescent↗
PubMed1987

Splenic artery and superior mesenteric artery blood flow: nonsurgical Doppler US measurement in healthy subjects and patients with chronic liver disease.

The accuracy of the duplex Doppler ultrasound system in the measurement of blood flow in the splenic artery and the superior mesenteric artery was evaluated in seven anesthetized dogs by comparing blood flow recordings obtained simultaneously with the electromagnetic flowmeter, with those obtained with the combination of B-mode and M-mode scanning. Various flow rates were produced by the infusion of dopamine. Splenic artery blood flow and superior mesenteric artery blood flow measured with the duplex system exhibited significant correlations with corresponding values obtained with electromagnetic flow measurements (r = .93 and r = .93, respectively). Changes in splanchnic circulation with the progression of chronic liver disease in humans were then investigated with the use of the duplex system. Splenic artery blood flow and superior mesenteric artery blood flow were significantly increased in patients with cirrhosis compared with patients with chronic hepatitis and healthy subjects. These results indicate that a hyperdynamic circulatory state may develop in the splanchnic circulation of the intestine and spleen in cirrhotic patients.

Adult↗
PubMed1999

Traumatic injury to the superior mesenteric artery.

BACKGROUND: Superior mesenteric artery (SMA) injuries are rare and devastating injuries incurring very high mortality rates. It is the purpose of this study to review our experience with these injuries, to analyze Fullen's classification based on anatomical zone and injury grade for its predictive value, and to correlate the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) for abdominal vascular injury with mortality. METHODS: Retrospective study was made over a 65-month period of all patients sustaining SMA injuries in an urban level I trauma center. RESULTS: Thirty-five patients, mean age 31, had a mean Revised Trauma Score of 5.86 and a mean Injurity Severity Score of 23. Mechanisms of injury were penetrating 27 (77%) and blunt 8 (23%). Mean admission systolic blood pressure was 85 mm Hg. Mean estimated blood loss was 8,500 mL and mean total fluid replacement 17,000 mL. Operating room findings were retroperitoneal hematoma in 34 (97%) and "black bowel" in 2 (6%). Number of associated injuries was nonvascular, mean 4.2, and vascular, mean 1.5. Surgical management consisted of ligation in 18 (51%), primary repair in 14 (40%), and interposition graft in 2 (6%). Overall mortality was 19 of 35 (54%). Mortality versus Fullen's zones was zone I, 100%, zone II, 43%, and zones III and IV, 25%. Mortality versus Fullen's ischemia grade was grade 1, 89%, grade 2, 58%, grade 3, 100%, and grade 4, 19%. Mortality versus AAST-OIS: was grade 1, 0%, grade II, 20%, grade III, 0%, grade IV, 59%, and grade V, 88%. CONCLUSIONS: SMA injuries are highly lethal. Most deaths are due to exsanguination. A higher number of associated vascular injuries increases mortality. "Black bowel" is an uncommon finding. Both Fullen's anatomical zones and the AAST-OIS for abdominal vascular injuries correlate with mortality. Fullen's ischemia grade does not.

Adult↗