• 제목/요약/키워드: mesenteric artery

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상장간막 동맥 폐쇄증의 혈전 제거술- 1예 보고 - (Thrombectomy of Superior Mesenteric Artery Occlusion - A case report -)

  • 이석열;백강석;전철우;이승진;이철세;이길노
    • Journal of Chest Surgery
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    • 제40권9호
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    • pp.641-644
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    • 2007
  • 50세 남자 환자가 갑작스런 복통으로 내원하였다. 다중 검출 복부 컴퓨터 단층촬영상 상장간막 동맥의 근위부 폐쇄가 관찰되었다. 입원 당일 응급으로 개복술을 실시하여 혈전제거술을 실시하였고 다음날 다시 혈전제거술과 일부 소장 절제를 하였다 저자들은 상장간막 동맥 폐쇄증을 치험하였기에 보고하는 바이다.

Splenic Artery Bleeding into the Extraperitoneal Space Mimicking Mesenteric Injury: A Rare Case of Blunt Trauma

  • Seo, Sang Hyun;Jung, Hyun Seok;Park, Chan Yong
    • Journal of Trauma and Injury
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    • 제34권2호
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    • pp.141-145
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    • 2021
  • Splenic injury is a common result of blunt trauma, and bleeding occurs mainly inside the splenic capsule and may leak into the peritoneal space. Herein, we report a case where active bleeding occurred in the splenic artery and only leaked into the extraperitoneal space. This is the first case of this phenomenon in a trauma patient in the English-language literature. Bleeding passed through the peritoneum, leaked into the anterior pararenal space, and continued along the extraperitoneal space to the prevesical space of the pelvis. Therefore, on the initial computed tomography (CT) scan, the bleeding appeared to be in the left paracolic gutter, so we suspected mesenteric bleeding. However, after the CT series was fully reconstructed, we accurately read the scans and confirmed splenic injury with active bleeding. If there had been a suspicion of bowel or mesenteric injury, surgery would have been required, but fortunately surgery could be avoided in this case. The patient was successfully treated with angioembolization.

A portal quadrad with triple hepatic arteries

  • Claire E Stoudemire;Caitlin N Sachsenmeier;Brittney L Link;Faith M Klein;Randy Kulesza
    • Anatomy and Cell Biology
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    • 제56권2호
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    • pp.276-279
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    • 2023
  • The arterial support of the liver is most commonly from the celiac trunk via the proper hepatic artery (PHA). The PHA divides into left and right branches: the right hepatic artery (RHA) supplies the right and caudate lobes while the left hepatic artery (LHA) supplies the left and quadrate lobes. Aberrant hepatic arteries are relatively common, and the most frequent contributors are the superior mesenteric artery and left gastric artery. Herein we present findings from postmortem dissection of an abdominal cavity that revealed a rare combination of reported variations. Specifically, this subject had three extrahepatic arteries - a replaced LHA (rLHA), a PHA, and a replaced RHA (rRHA). The rLHA originated from the left gastric and the rRHA originated from the superior mesenteric artery. Knowledge of these variations is important for surgical and radiological procedures to avoid complications during treatment and improve patient outcomes.

Panax 속 한약재가 흰쥐 혈관운동성에 미치는 영향에 관한 비교 연구 (The Effects of Water Extract of Genus Panax on Rat Blood Vessels)

  • 유기덕;최호영;이재성;안덕균;김형환
    • 대한한의학회지
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    • 제25권1호
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    • pp.60-71
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    • 2004
  • Objectives : We have examined the relaxational response to the water extract of genus Panax in rat thoracic aorta and mesenteric artery. Methods : Segments of thoracic aorta and mesenteric artery obtained from rats immediately after delivery were mounted in organ baths superfused on a polygraph. Results : We found that the thoracic aorta segments responded to the water extract of genus Panax with a dose-dependent vasorelaxation. At $10^{-5}m$ 5-hydroxytrptamine (5-HT), the maximal contraction force were 94.9% of the maximum KCl-response. At $10^{-5}m$ 5-HT - induced contraction, The contractile response of thoracic aortic rings were inhibited by 54.7%, 36.3% and 31.3% after addition of the high concentration (100 mg/ml) of water extract of Panax ginseng, Panax japonicus and Panax quinquefolium. The contractile response of mesenteric arteries were inhibited by 88.3%, 87.7%, and 70.3% after addition of the high concentration (100 mg/ml) of water extract of Panax ginseng, Panax japonicus and Panax quinquefolium. Conclusions : In conclusion, water extract of genus Panax - induced relaxation in the isolated rat thoracic aorta and mesenteric artery were composed of endothelium - independent relaxation and dose - dependent relaxation.

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원발성 동맥염에 의한 신혈관성 고혈압의 외과적 치료 :1례 보고 (Surgical Treatment of Renovascular Hypertension Due to Primary Arteritis)

  • 김주이
    • Journal of Chest Surgery
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    • 제14권2호
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    • pp.175-178
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    • 1981
  • Since the first report by Freeman of renal artery repair for renovascular hypertension in 1954, there has been a gradual improvement in the results of renovascular reconstruction. This is case report of renovascular hypertension due to diffuse primary arteritis, which was performed aorto-bllateral renal bypass graft with using of Y -woven dacron graft. This 33 y-o male has complained intermittent headache, facial edema & malignent hypertension symptoms for 1.5 years. He had the history of Rt. B-K amputation due to unhealed wound after trauma of the Rt. great toe about 7 years ago. The abdominal aortography revealed nearly not visualized the Rt. renal artery & severe narrowing of the Lt. renal arterly. During postop. course, Blood pressure was well controlled. At postop. 3rd week, systolic pressure was down to 130-140mmHg But, diastolic pressure was remained to 100-110mmHg. At postop. 30th day, exploration was done due to intestinal obstruction signs. But severe ischemic enteritis was occured due to fibrotic obstruction of the superior mesenteric artery. The next day, he was dead. in spite of Rt. common iliac artery-sup. mesenteric artery bypass graft.

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외상 후 지연성으로 발생한 장간막 동정맥루: 증례보고 (Delayed Presentation of a Post-traumatic Mesenteric Arteriovenous Fistula: A Case Report)

  • 조자윤;정희경;김형기;임경훈;천재민;허승;박진영
    • Journal of Trauma and Injury
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    • 제26권3호
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    • pp.248-251
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    • 2013
  • Introduction: A post-traumatic mesenteric arteriovenous fistula (AVF) is extremely rare. Case Report: A previously healthy 26-year-old male was injured with an abdominal stab wound. Computed tomography (CT) showed liver injury, pancreas injury and a retropancreatic hematoma. We performed the hemostasis of the bleeding due to the liver injury, a distal pancreatectomy with splenectomy and evacuation of the retropancreatic hematoma. On the 5th postoperative day, an abdominal bruit and thrill was detected. CT and angiography showed an AVF between the superior mesenteric artery (SMA) and the inferior mesenteric vein with early enhancement of the portal vein (PV). The point of the AVF was about 4 cm from the SMA's orifice. After an emergent laparotomy and inframesocolic approach, the isolation of the SMA was performed by dissection and ligation of adjacent mesenteric tissues which was about 6 cm length from the nearby SMA orifice, preserving the major side branches of the SMA, because the exact point of the AVF could not be identified despite the shunt flow in the PV being audible during an intraoperative hand-held Doppler-shift measurement. After that, the shunt flow could not be detected by using an intraoperative hand-held Doppler-shift measuring device. CT two and a half months later showed no AVF. There were no major complications during a 19-month follow-up period. Conclusion: Early management of a post-traumatic mesenteric AVF is essential to avoid complications such as hemorrhage, congestive heart failure and portal hypertension.

Vasorelaxing Mechanism of Crude Saponin of Korea Red Ginseng in the Resistance-sized Mesenteric Artery of Rat

  • Kim, Shin-Hye;Park, Hyung-Seo;Lee, Mee-Young;Oh, Young-Sun;Kim, Se-Hoon
    • Journal of Ginseng Research
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    • 제26권1호
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    • pp.1-5
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    • 2002
  • 고려홍삼은 혈압강하효과가 있음이 잘 알려져 있다. 이에 백서장간막이 동맥의 저항혈관에서 고려홍삼 사포닌 성분의 혈관 이완기전을 규명하고자 내경이 150$\mu\textrm{m}$이하의 작은 혈관을 이요하여 여러 실험 조건에서 장력의 변화를 측정하여 다음과 같은 결과를 얻었다. 고려홍삼 사포닌 성분은 농도 의존적으로 (0.01mg/$m\ell$~1mg/$m\ell$) 혈관 평활근을 이완시켰으며 내피세포를 제거한 상태에서도 혈관의 이완효과는 지속되었다. A23187 이나 phorbol 12, 13-dibutyrate 에 의한 수축에서는 고려홍삼 사포닌에 의한 혈관의 이완효과가 나타나지 않았다. 고려홍삼 사포닌에 의한 혈관이완효과는 실험용액의 $K^{+}$ 농도를 증가시키면 감소되었으며 각종 $K^{+}$이 온통로 억제제인 tetaethylammonium, glybenclamide, 4-aminopyridine 및 BaCl$_2$를 전처치한 결과 BaCl$_2$에 의해서만 농도에 의존적으로 고려홍삼 사포닌에 의한 혈관이완작용이 억제되었다. 이상의 실험결과로부터 고려홍삼 사포닌은 장간막 동맥의 저항혈관에서 $K^{+}$의 유출을 증가시켜 혈관평활근을 이완시키며 $Ba^{2+}$에 의하여 차단되는 $K^{+}$ 이온통로가 고려홍삼 사포닌에 의한 혈관이완작용에 관여함을 알 수 있었다.

Characterization of $ET_B$ Receptor-mediated Relaxation in Precontracted Mesenteric Artery from Streptozotocin-induced Diabetic Rats

  • Eom, Yang-Ki;Kim, Koan-Hoi;Rhim, Byung-Yong
    • The Korean Journal of Physiology and Pharmacology
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    • 제9권5호
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    • pp.305-314
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    • 2005
  • Diabetes mellitus is associated with vascular complications, including an impairment of vascular function and alterations in the reactivity of blood vessels to vasoactive substances in various vasculature. In the present study, the authors have observed endothelin-B ($ET_B$) receptor agonist-induced relaxation in precontracted mesenteric arterial segments from streptozotocin (STZ)-induced diabetic rats, which was not shown from control rats or in other arterial segments from diabetic rats. Accordingly, the goal of this study was to investigate in what way STZ-induced diabetes altered reactivity of the mesenteric arterial bed and to examine the causal relaxation, if any, between this $ET_B$ receptor-mediated relaxation and endothelial paracrine function, especially nitric oxide (NO) production. The relaxation induced by $ET_B$ agonists was not observed in mesenteric arteries without endothelium. The relaxation to $ET_B$ agonists was completely abolished by pretreatment with BQ788, but not by BQ610. $N_{\omega}-nitro-L-arginine$ methyl ester and soluble guanylate cyclase inhibitors, methylene blue or LY83583 significantly attenuated the relaxant responses to $ET_B$ agonists, respectively. When the expression of eNOS and iNOS was evaluated on agarose gel stained with ethidium bromide, the expression of eNOS mRNA in diabetic rats was significantly decreased, but the expression of iNOS was increased compared with control rats. Furthermore, the iNOS-like immunostaining was densely detected in the endothelium and slightly in the arterial smooth muscle of diabetic rats, but not in control rats. These observations suggest that $ET_B$ receptor may not play a role in maintaining mesenteric vascular tone in normal situation. However, the alterations in $ET_B$ receptor sensitivity were found in diabetic rats and lead to the $ET_B$ agonist-induced vasorelaxation, which is closely related to NO production. In the state of increased vascular resistance of diabetic mesenteric vascular bed, enhanced NO production by activation of iNOS could lead to compensatory vasorelaxation to modulate adequate perfusion pressure to splanchnic area.

Calcium-activated Ionic Currents in Smooth Muscle Cells from Rabbit Superior Mesenteric Artery

  • Lee, Moo-Yeol;Bang, Hyo-Weon;Uhm, Dae-Yong;Rhee, Sang-Don
    • The Korean Journal of Physiology
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    • 제28권2호
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    • pp.151-157
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    • 1994
  • Intracellular free $Ca^{2+}$ contributes to regulation of various events occurring in vascular smooth muscle cells. One of these events is modulating the membrane iou currents. Single smooth muscle cells were isolated from rabbit mesenteric artery. Three kinds of $Ca^{2+}-activated\;current$ were studied with the patch clamp method. $Ca^{2+}-activated\;K^+\;current$ with a large oscillation was recorded in the depolarized potential range. The single channel conductance of this current was about 250 pS. It was abolished by replacing intracellular $K^+\;with\;Cs^+$. A $Ca^{2+}-activated$ nonselective cation current was observed in both the depolarized and hyperpolarized potential ranges. And it was blocked by replacement of extracellular $Na^+$ with N-methylglucamine (NMG) or extracellular application of $Cd^{2+}$. $Ca^{2+}-activated\;Cl^-\;current$ was revealed in the whole voltage range and was blocked by niflumic acid. These results indicate that at least three kinds of $Ca^{2+}-activated$ ionic currents exist in smooth muscle cells from rabbit superior mesenteric artery.

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Open Surgical Repair Using the Femoral Vein for a Mycotic Superior Mesenteric Artery Aneurysm

  • Namkoong, Min;Hong, Seok Beom;Kim, Hwan Wook;Jo, Keon Hyon;Kim, Jang Yong
    • Journal of Chest Surgery
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    • 제51권3호
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    • pp.209-212
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    • 2018
  • Superior mesenteric artery (SMA) aneurysms are rare and often fatal. A 72-year-old man had previously been admitted to the emergency room with epigastric pain and heart murmur. The echocardiographic diagnosis was vegetation on the aortic and mitral valves, with moderate regurgitation from both valves due to infective endocarditis. No aneurysm was detected on abdominal computed tomography, and emergency double-valve replacement was performed. On postoperative day 25, the patient experienced abrupt abdominal pain, and computed tomography revealed a mycotic SMA aneurysm. Open surgical repair of the SMA aneurysm was performed using the femoral vein, and the patient's postoperative course was uneventful.