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Abdominal > Wk6 > Flashcards

Wk6 Flashcards

1
Q

Mesenteric risk factors

A 
Hypertension 
Smoking
Diabetes 
Hyperlipidemia
Age
Female
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2
Q

Mesenteric indications

A 
Abdominal pain/cramping while eating. 
Abdominal bruit. 
Post-prandial pain. 
Unintended/unexplained weight loss.
Post op
Visceral aneurysm 
Other GI symptoms
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3
Q

Cause of chronic mesenteric ischemia

A

Atherosclerosis and thrombosis

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4
Q

Cause of acute mesenteric ischemia

A

Embolism

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5
Q

Cause of non occlusive disease

A

Low cardiac output

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6
Q

Cause of mesenteric vein thrombosis

A

Hypercoaguability

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7
Q

Cause of MALS

A

Celiac trunk compressed by median arcuate ligament

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8
Q

A cute mesenteric ischemia

A

Sudden onset of abdominal symptoms and rapid progression to life threatening condition.
Abdominal pain
Bowel evacuation
Abdominal distribution, fever, shock

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9
Q

Acute mesenteric ischemia manifestations

A

Surgical emergency
70% death rate
Ultrasound not used for acute
Most often involves SMA

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10
Q

Chronic mesenteric ischemia

A 
2 if 3 vessels
Unintended weight loss
Fear of food
Post-prandial pain-30-60 min after eating
Diarrhea
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11
Q

MALS

A

Median arcuate ligament syndrome

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12
Q

What is MALS

A

Compression of celiac trunk by median arcuate ligament.
Rarely causes ischemia.
Found incidentally on duplex, changes with breathing normalized with deep inspiration.
Younger women.

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13
Q

What to do when MALS suspicion

A

Patient hold breath and reevaluate celiac trunk.

Compare Deep inspiration to complete exhalation

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14
Q

Other mesenteric pathology

A

Visceral aneurysms-rare, splenic artery most common.

Dissection-common SMA site, causes are atherosclerosis/FMS/trauma

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15
Q

Celiac stenosis criteria

A

70%: PSV >200

50%: EDV: >55

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16
Q

SMA stenosis

A

70%: PSV>275

50%:EDV>45

17
Q

Treatment options

A 
Angioplasty 
Stent
Arteriotomy
Vein patch
Decompress median arcuate ligament 
Surgery-bypass, endarterectomy 
Bypass-native vein or material
18
Q

Bypass grafts

A 
Can be from
Supraceliac aorta
Infrarenal aorta
SMA to celiac 
Celiac to SMA
Iliac to SMA
Need operative report or surgeon feedback
19
Q

Bypass graft or stent surveillance

A 
Long images
Velocity of:
Inflow
Prox anas
Prox stent
Mid stent
Dist stent 
Dist anas
Outflow

Abdominal (7 decks)

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