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Duplex Ultrasonography of the Mesenteric Circulation

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Noninvasive Vascular Diagnosis

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Abstract

Arterial occlusive disease of the celiac and superior mesenteric arteries is rare and patients with symptomatic mesenteric ischemia are encountered infrequently. However, the clinical manifestations of mesenteric arterial occlusive lesions remain enigmatic and range from asymptomatic to catastrophic. Acute occlusions of the celiac artery (CA) and the superior mesenteric artery (SMA) due to thrombosis or embolism can produce extensive, irreversible gut ischemia requiring emergency treatment, and the mortality from these events remains among the highest of all vascular emergencies.

In this chapter, we review duplex scanning technique and findings in both normal and diseased states. Clinical applications including visceral artery aneurysms, celiac artery compression syndrome, and visceral ischemic syndromes are discussed. In this chapter, we have also incorporated more recent data related to post-procedure surveillance of both open surgical reconstruction and endovascular intervention.

Mesenteric duplex scanning can become a routine noninvasive diagnostic testing modality for the evaluation of patients with suspected visceral ischemia since earlier diagnosis and treatment will significantly reduce the risk of catastrophic gut infarction in these patients. Like all deep abdominal duplex scanning, mesenteric scanning is more technologically demanding than scanning vessels of the neck or extremities. However, continued refinement of the duplex instrumentation make these examinations exciting areas of clinical advancement.

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Author information

Authors and Affiliations

  1. Department of Surgery, The Maryland Vascular Center, Baltimore Washington Medical Center, University of Maryland School of Medicine, 301 Hospital Drive, Baltimore, MD, 21061, USA

    David G. Neschis M.D.

  2. Division of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD, USA

    William R. Flinn M.D.

Authors
  1. David G. Neschis M.D.
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  2. William R. Flinn M.D.
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Corresponding author

Correspondence to David G. Neschis M.D. .

Editor information

Editors and Affiliations

  1. Robert C. Byrd Health Sciences Center, Dept. Surgery, West Virginia University, MacCorkle Ave. SE 3100, Charleston, 25304, West Virginia, USA

    Ali F. AbuRahma

  2. , Interventional Cardiology, UC San Diego Sulpizio Cardiovascular Cen, 9300 Campus Point Drive 7784, La Jolla, 92037, California, USA

    Dennis F. Bandyk

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Neschis, D.G., Flinn, W.R. (2013). Duplex Ultrasonography of the Mesenteric Circulation. In: AbuRahma, A., Bandyk, D. (eds) Noninvasive Vascular Diagnosis. Springer, London. https://doi.org/10.1007/978-1-4471-4005-4_49

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  • DOI: https://doi.org/10.1007/978-1-4471-4005-4_49

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  • Online ISBN: 978-1-4471-4005-4

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