Author/Editor     Norčič, Gregor; Jelenc, Franc; Starc, Radovan
Title     Neokluzivna mezenterična ishemija
Translated title     Non-occlusive mesenteric ischemia
Type     članek
Source     Gastroenterolog
Vol. and No.     Letnik 10, št. 23
Publication year     2006
Volume     str. 37-43
Language     slo
Abstract     Aetiology, clinical presentation, diagnosis, and therapy of non-occlusive mesenteric ischemia (NOMI) are presented. NOMI is a form of acute mesenteric ischemia resulting from the functional disturbances of mesenteric circulation, and not from mechanical reasons, which is typical for atherosclerotic, thrombotic or embolic acute occlusion of mesenteric arteries. NOMI is caused by acute systemic hemodynamic insult of cardiac or noncardiac origin. The symptoms of NOMI are often atypical and masked by symptoms of other conditions. Fast and appropriate diagnosis is of utmost importance for the survival of patients. Mesenteric angiography is the gold standard method offering at the same time the possibility of percutaneous treatment. NOMI is principally treated by removing the cause of haemodynamic insult and by papaverine infusion into mesenteric arteries via the angiographic catheter. Surgical treatment is indicated only in the case of intestinal gangrene, as opposed to other acute ischemia. Appropriate treatment improves otherwise poor prognosis of NOMI.
Summary     Opisani so nastanek, klinična slika, diagnostika in terapija neokluzivne mezenterične ishemije (NOMI), ki je le ena od oblik akutne ishemije mezenterija. Njeni vzroki so funkcijski in ne mehanični, kot so pri aterosklerotični ali embolični zapori mezenteričnih arterij. NOMI nastane zaradi akutne hemodinamske motnje srčne ali zunajsrčne geneze. Simptomi NOMI niso značilni in so pogosto prekriti s simptomi drugih bolezenskih stanj. Za preživetje bolnikov z NOMI je odločilnega pomena hitra in ustrezna diagnostična obravnava. Preiskava zlatega standarda za NOMI je selektivna angiografija, ki hkrati omogoča tudi perkutano zdravljenje. NOMI zdravimo z odpravo vzroka za nastalo hemodinamsko motnjo in z infuzijami papaverina v mezenterično žilje po angiografskem katetru. Za razliko od drugih akutnih ishemij je kirurško zdravljenje NOMI indicirano le pri gangreni črevesja. Ustrezna obravnava izboljša sicer slabo prognozo.
Descriptors     MESENTERIC ARTERIES
MESENTERIC VEINS
ISCHEMIA
EMBOLISM
THROMBOSIS