Outcome of splanchnic blood flow determination in patients with suspected chronic intestinal ischaemia. A retrospective survey.

TY - JOUR

T1 - Outcome of splanchnic blood flow determination in patients with suspected chronic intestinal ischaemia. A retrospective survey.

AU - Møller, Søren

AU - Madsen, Jan Lysgård

PY - 2002

Y1 - 2002

N2 - BACKGROUND: Different diagnostic examinations have been applied in the management of patients with suspected intestinal ischaemia. In some centres, invasive determination of a meal-induced increase in splanchnic blood flow is used in the diagnostic process and in the selection of patients for surgery. However, no studies have evaluated the impact of splanchnic blood flow determination on therapy in such patients. OBJECTIVE: The aim of the present study was therefore to analyse the outcome of splanchnic blood flow determination in patients with suspected chronic intestinal ischaemia. METHODS: Seventy-three consecutive patients with suspected intestinal ischaemia were included during a 5-year period. Splanchnic blood flow was determined at baseline and after a standardized meal. The patients were classified into three groups according to the level of meal-induced increase in splanchnic blood flow: A, normal response (splanchnic blood flow > or = 200 ml/min); B, possible abnormal response (splanchnic blood flow 51-199 ml/min); and C, definitive abnormal response (splanchnic blood flow < or = 50 ml/min). Where surgery took place, the type of operation was noted. RESULTS: Forty patients had a normal meal-induced response, 23 patients had a possible abnormal response and 10 patients had a definitive abnormal response, which gave evidence of chronic intestinal ischaemia. In the total patient population, the increase in splanchnic blood flow was significantly correlated to an increase in hepatic oxygen uptake (r = 0.38, P < 0.002) and to body weight (r = 0.36, P < 0.01). A total of seven patients (10%) underwent successful revascularization. CONCLUSIONS: Ten of the patients with suspected chronic intestinal ischaemia had abnormal meal-induced splanchnic blood flow and 30% of these patients underwent angioplasty. Future studies are needed to validate the determination of splanchnic blood flow in relation to splanchnic angiography and other imaging modalities in patients with chronic intestinal ischaemia.

AB - BACKGROUND: Different diagnostic examinations have been applied in the management of patients with suspected intestinal ischaemia. In some centres, invasive determination of a meal-induced increase in splanchnic blood flow is used in the diagnostic process and in the selection of patients for surgery. However, no studies have evaluated the impact of splanchnic blood flow determination on therapy in such patients. OBJECTIVE: The aim of the present study was therefore to analyse the outcome of splanchnic blood flow determination in patients with suspected chronic intestinal ischaemia. METHODS: Seventy-three consecutive patients with suspected intestinal ischaemia were included during a 5-year period. Splanchnic blood flow was determined at baseline and after a standardized meal. The patients were classified into three groups according to the level of meal-induced increase in splanchnic blood flow: A, normal response (splanchnic blood flow > or = 200 ml/min); B, possible abnormal response (splanchnic blood flow 51-199 ml/min); and C, definitive abnormal response (splanchnic blood flow < or = 50 ml/min). Where surgery took place, the type of operation was noted. RESULTS: Forty patients had a normal meal-induced response, 23 patients had a possible abnormal response and 10 patients had a definitive abnormal response, which gave evidence of chronic intestinal ischaemia. In the total patient population, the increase in splanchnic blood flow was significantly correlated to an increase in hepatic oxygen uptake (r = 0.38, P < 0.002) and to body weight (r = 0.36, P < 0.01). A total of seven patients (10%) underwent successful revascularization. CONCLUSIONS: Ten of the patients with suspected chronic intestinal ischaemia had abnormal meal-induced splanchnic blood flow and 30% of these patients underwent angioplasty. Future studies are needed to validate the determination of splanchnic blood flow in relation to splanchnic angiography and other imaging modalities in patients with chronic intestinal ischaemia.

M3 - Journal article

SN - 0954-691X

VL - 14

SP - 1193

EP - 1197

JO - European Journal of Gastroenterology and Hepatology

JF - European Journal of Gastroenterology and Hepatology

IS - 11

ER -