title: Mesenteric Infarction: Clinical Outcomes After Restoration of Bowel Continuity.
abstract: BACKGROUND
  Patients who have a bowel resection for mesenteric infarction may require parenteral nutrition (PN). This study primarily aimed to determine the aetiological factors for a mesenteric infarction and the effects of restoring bowel continuity on the long-term PN requirements.
  
  
  METHODS
  A retrospective review of data on patients treated for mesenteric infarction from 2000 to 2010.
  
  
  RESULTS
  A total of 113 patients (61 women, median age 54 years) were identified. Seventy-four (65%) had a superior mesenteric artery thromboembolism, 25 (22%) had a superior mesenteric vein thrombosis, and 4 (3%) had superior mesenteric artery stricture or spasm. Patients younger than 60 years most commonly had a clotting abnormality (n = 23/46, 50%), whereas older patients had a cardiological risk factor (n = 11/17, 65%). All patients with a jejunostomy required long-term PN. Fifty-seven (49%) patients had restoration of bowel continuity (colon brought into circuit). After this, PN was stopped within 1 year in 20 (35%), within 2 years in 29 (50%) patients and within 5 years in 44 (77%) patients (P = 0.001).
  
  
  CONCLUSIONS
  A thrombotic tendency is the main etiological factor in most patients younger than 60 years. An anastomosis of the remaining jejunum to the colon can allow PN to be stopped.
authors.affiliation: Intestinal Failure Unit, St Mark's Hospital, Harrow, UK.
authors.forename: Franklin
authors.initials: F
authors.lastname: Adaba
authors.forename: Arun
authors.initials: A
authors.lastname: Rajendran
authors.forename: Amit
authors.initials: A
authors.lastname: Patel
authors.forename: Yee-Kee
authors.initials: YK
authors.lastname: Cheung
authors.forename: Katherine
authors.initials: K
authors.lastname: Grant
authors.forename: Carolynne J
authors.initials: CJ
authors.lastname: Vaizey
authors.forename: Simon M
authors.initials: SM
authors.lastname: Gabe
authors.forename: Janindra
authors.initials: J
authors.lastname: Warusavitarne
authors.forename: Jeremy M D
authors.initials: JM
authors.lastname: Nightingale
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D000925:Anticoagulants / Q000627:therapeutic use; D003106:Colon / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007238:Infarction / Q000209:etiology / Q000628:therapy*; D007582:Jejunostomy; D007583:Jejunum / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D065666:Mesenteric Ischemia / Q000209:etiology / Q000628:therapy*; D008643:Mesentery / Q000098:blood supply*; D008875:Middle Aged; D010288:Parenteral Nutrition; D012189:Retrospective Studies; D012308:Risk Management; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants