Pharmacologic management of mesenteric occlusive disease.
Mesenteric vascular disease has been diagnosed increasingly over the past 25 years. This rise in incidence has been attributed to the advanced mean age of the population, an increasing number of critically ill patients and a greater clinical recognition of the condition. Although surgical revascularization and resection has long been the standard of treatment, medical management can also play an important adjunctive role. Early diagnosis before irreversible bowel damage, which may occur within 6-8 hours after the insult, is necessary to improve survival and reduce morbidity. Even in the presence of irreversible bowel ischemia, perioperative medical treatment may reduce disease progression, enabling more limited bowel resection. This article outlines the appropriate pharmacologic management of ischemic disorders of the intestine, with an emphasis on the pharmacologic treatments presently being used in clinical practice and those being studied in the laboratory.
Frishman
William H
WH
Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, New York 10595, USA. William_Frishman@nymc.edu
Novak
Sofia
S
Brandt
Lawrence J
LJ
Spiegel
Adam
A
Gutwein
Andrew
A
Kohi
Maureen
M
Rozenblit
Grigory
G
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D003106:Colon / Q000098:blood supply; D004617:Embolism / Q000150:complications / Q000188:drug therapy; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D007511:Ischemia / Q000188:drug therapy / Q000209:etiology; D008641:Mesenteric Vascular Occlusion / Q000188:drug therapy*; D008643:Mesentery / Q000098:blood supply; D011480:Protease Inhibitors / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000150:complications / Q000188:drug therapy; D014665:Vasodilator Agents / Q000627:therapeutic use; D020246:Venous Thrombosis / Q000188:drug therapy / Q000209:etiology
D000806:Angiotensin-Converting Enzyme Inhibitors; D000925:Anticoagulants; D016166:Free Radical Scavengers; D011480:Protease Inhibitors; D014665:Vasodilator Agents