Abstract
Acute intestinal ischemia represents a rare but often fatal disease. In retrospective analysis, up to 86% with this complication had a prior history of cardiovascular disease (Irvinen et al. Ann Chir Gynaecol 83:22-25, 1994). It is also a rare but well-known complication in severe thermally injured patients. Here, we describe our experience with this disease in our critically ill patients suffering from acute thermal injury. In a retrospective analysis of 634 patients who were treated at our burn care center, three patients were identified with intestinal ischemia. Two patients with non-occlusive disease during continuous veno-venous hemofiltration died, while one patient with arterial embolism in a superior mesenteric artery branch survived. Acute intestinal ischemia is a severe and life-threatening complication in thermally injured patients. It can occur even days after the acute trauma and diagnostic criteria are often insecure.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kowal-Vern A, McGill V, Gamelli RL (1997) Ischemic necrotic bowel disease in thermal injury. Arch Surg 132:440–443
Grothues F, Bektas H, Klempnauer J (1996) Surgical therapy of acute mesenteric ischemia. Langenbecks Arch Chir 381:275–282
Uryama H, Ohtake H, Kawakami T, Tsunezuka Y, Yokoi K, Watanabe Y (1998) Acute mesenteric vascular occlusion: analysis of 39 cases. Eur J Surg 164:195–200
Park WM, Gloviczki P, Cherry KJJ (2002) Contemporary management of acute mesenteric ischemia: factors associated with survival. J Vasc Surg 35:445–452
Meyer T, Klein P, Schweiger H, Lang W (1998) Wie kann die Prognose der akuten mesenterialarterien Ischämie verbessert werden? Ergebnisse einer retrospektiven Analyse. Zentralbl Chir 123:230–234
Bjorck M, Acosta S, Linberg F, Troeng T, Bergqvist D (2002) Revascularisation of the superior mesenteric artery after acute thromboembolic occlusion. Br J Surg 89:923–929
Brunaud L, Antunes L, Collinet-Adler S, Marchal F, Ayav A, Bresler L, Boissel P (2001) Acute mesenteric venous thrombosis: case for nonoperative management. J Vasc Surg 34:673–679
Rhee GP, Mendonca CT et al (1994) Mesenteric venous thrombosis: still a lethal disease in the 1990s. J Vasc Surg 20:688–697
Eckstein HH (2003) Acute mesenteric ischemia. Resection or reconstruction? Chirurg 74:419–431
Desai MH, Herndon DN, Rutan RL, Abston S, Linares HA (1991) Ischemic intestinal complications in patients with severe burns. Surg Gynecol Obstet 172:257–261
Look G (2002) Acute mesenteric ischemia: classification, evaluation and therapy. Acta Gastroenterol Belg 65:220–225
Izbicki JR, Schneider CG, Kastl S (2003) Partial ischemia. Occlusive and nonocclusive mesenteric ischemia, ischemic colitis, systemic lupus erythematosus. Chirurg 74:413–418
Inderbitzi R, Hassler H, Teuscher J, Stirnemann P (1990) The acute mesenteric ischemia. Chirurg 61:530–534
Endean ED, Barnes SL, Kwolek CJ, Minion DJ, Schwarcz TH, Mentzer RMJ (2001) Surgical management of thrombotic acute intestinal ischemia. Ann Surg 233:801–808
Ghandi SK, Hanson MM, Vernava A, Kaminski DL, Longo WE (1996) Ischemic colitis. Dis Colon Rectum 39:88–100
Schunn CDG, Daly JM (1995) Small bowel necrosis associated with post-operative jejunal tube feeding. J Am Coll Surg 180:410–416
Saffle JR, Graves C (2007) Nutritional support of the burned patient. In: Total burn care, Ed.: d:n: Herndon; 3. ed. Saunders Elsevier, pp 398-419
Herndon DN, Zeigler ST (1993) Bacterial translocation after thermal injury. Crit Care Med 21:50–54
Fadros T, Traber DL, Herndon DN (2000) Hepatic blood flow and oxygen consumption after burn and sepsis. J Trauma 49:101–108
Kincaid MS, Vavilala MS, Faucher L, Zimmermann J, Heimbach D (2004) Feeding intolerance as a result of small-intestine intussusception in a child with najor burns. J Burn Care Rehabil 25:212–214
Schoots IG, Koffeman GI, Legemate DA, Levi M, van Gulik TM (2004) Systematic review of survival after acute mesenteric ischemia according to disease aetiology. Br J Surg 91:17–27
Irvinen O, Laurikka J, Salenius JP, Tarkka M (1994) Acute intestinal ischemia. A review of 214 cases. Ann Chir Gynaecol 83:22–25
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kaun, M., Mailänder, P., Machens, HG. et al. Acute intestinal ischemia—a rare and underestimated complication in thermally injured patients. Eur J Plast Surg 33, 79–82 (2010). https://doi.org/10.1007/s00238-009-0385-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00238-009-0385-9