title: A simple but useful method of screening for mesenteric ischemia secondary to acute aortic dissection.
abstract: BACKGROUND
  In spite of recent improvements in treatment for acute aortic dissection, mesenteric ischemia secondary to aortic dissection is still challenging. We propose a simple screening method to detect mesenteric ischemia secondary to acute aortic dissection.
  
  
  METHODS
  From 1991 to 2002, 245 patients with acute aortic dissection were admitted to our hospital. Nine (3.7%) of those were complicated with mesenteric ischemia. The clinical records of those 9 patients were retrospectively analyzed. The ratios of the diameter of the superior mesenteric vein (SMV) to that of the superior mesenteric artery (SMA) were calculated in patients with mesenteric ischemia (group M) and in patients without mesenteric ischemia (group C). Blood test data, including results of arterial blood gas analysis, in the 2 groups were also compared.
  
  
  RESULTS
  The SMV/SMA ratios in groups M and C were 1.16 +/- 0.33 and 1.78 +/- 0.29, respectively (P=.003). A cutoff value of the SMV/SMA ratio was 1.5 (sensitivity, 88.9%; specificity, 88.9%) with an odds ratio of 64.0. Although there were differences between the 2 groups in glutamate oxaloacetate transaminase, lactate dehydrogenase, creatine phosphate kinase, pH, and lactate values, the measurement of lactate was especially useful (P=.002).
  
  
  CONCLUSIONS
  The combination of the SMV/SMA ratio and lactate concentration is a useful screening method to detect mesenteric ischemia secondary to acute aortic dissection.
authors.affiliation: Department of Traumatology and Critical Care Medicine, Sapporo Medical University, Sapporo, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kurimoto
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Morishita
authors.forename: Johji
authors.initials: J
authors.lastname: Fukada
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Kawaharada
authors.forename: Kanshi
authors.initials: K
authors.lastname: Komatsu
authors.forename: Naoya
authors.initials: N
authors.lastname: Yama
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Asai
authors.forename: Tomio
authors.initials: T
authors.lastname: Abe
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging*; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging*; D001837:Body Weights and Measures; D005260:Female; D006801:Humans; D007511:Ischemia / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008403:Mass Screening / Q000379:methods; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D008642:Mesenteric Veins / Q000000981:diagnostic imaging; D008643:Mesentery / Q000098:blood supply*; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019344:Lactic Acid