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Intestinal ischemia disorders: pathophysiology and management

1999; Elsevier BV; Volume: 30; Issue: 4 Linguagem: Inglês

10.1016/s0741-5214(99)70128-x

1097-6809

Robert M. Zwolak, John M. Porter,

Medical and Biological Ozone Research

Intestinal ischemia disorders: pathophysiology and management Waker Longo, Gary Peterson, Donald Jacobs; St Louis; 1999; QMP; 129 pages; $85.00. Intestinal ischemic disorders is a 16-chapter volume that includes not only the topics of pathophysiology and management, as the title implies, but also several strong chapters on diagnostic evaluation. The editors tackled a subject that is rarely the topic of an entire text, and, for that reason alone, this book deserves significant attention. Scott Boley, an authority on mesenteric vascular disease for almost three decades, writes an interesting historic perspective. It reminds the reader that our ability to diagnose and treat this disorder is a remarkably recent event and that outcomes are still suboptimal in many settings. Boley reminds us that, with heightened awareness, aggressive use of angiography hemodynamic optimization, and surgical intervention, the mortality rate can be as low as 30%. Only one chapter of this text focuses exclusively on pathophysiology. This is an exhaustive review of the reperfusion-based tissue injury at the molecular, cellular, and organ level, and it will serve as an excellent foundation for anyone embarking on research in mesenteric ischemia. Two complementary chapters present noninvasive and angiographic arterial imaging. The noninvasive chapter focuses on duplex ultrasound scanning and magnetic resonance, with a thorough review of the former. The angiography chapter is especially comprehensive, with a tabular summary of mesenteric angioplasty, a discussion of endovascular therapy for all forms of visceral artery disease, and many excellent images. It also contains a helpful techniques section on angioplasty and stenting for mesenteric atherosclerosis, fibromuscular dysplasia, median arcuate ligament syndrome, and bypass graft stenosis. Four subsequent chapters address standard therapy for the common forms of acute and chronic arterial and venous disease of the mesenteric vessels. These chapters follow traditional headings of acute occlusive arterial disease, nonocclusive mesenteric ischemia, chronic mesenteric ischemia, and mesenteric venous disease. Each is well organized, concise, and for the most part presents current best concepts regarding means to treat these complex disorders. The remainder of this book addresses unusual mesenteric vascular disorders and important ancillary clinical issues. These include chapters on ischemic colitis, unusual causes of mesenteric ischemia, aortic and cardiac surgery resulting in visceral ischemia, intraoperative assessment of intestinal viability, management and complications of intestinal resection, intensive care unit management, and a look at current research. They are all clearly written with excellent reference lists. Overall, this book deserves praise for content, organization, excellent illustrations, complete bibliographies, and a functional index. It is probably the most up-to-date summary of mesenteric vascular disease currently in print. As such, it is a timely addition to the vascular specialist’s library.