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Gastrointestinal Failure

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General Surgery

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Pearls and Pitfalls

  • Early aggressive fluid resuscitation is necessary to treat intestinal mucosal hypoperfusion associated with shock states to avoid non-occlusive mesenteric ischemia.

  • Intestinal failure is defined as the reduction of functional gut mass below the minimal amount necessary for digestion and absorption adequate to satisfy the nutrient and fluid requirements for maintenance in adults or growth in children.

  • Stress-related mucosal disease (SRMD) is multiple superficial erosions occurring in the proximal stomach involving superficial capillaries secondary to mucosal hypoperfusion.

  • SRMD is commonly associated with UGI bleeding, but gastric perforations are rare.

  • Mechanical ventilation and coagulopathy are the two greatest risk factors for SRMD.

  • Acid suppression therapy should be instituted in all patients at risk for SRMD.

  • Acute colonic pseudo-obstruction (ACPO) presents with features of large bowel obstruction, without a mechanical cause and is due to an imbalance in the...

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Author information

Authors and Affiliations

  1. Division Chief, Acute Care Surgery [Trauma, Burn, Critical Care, Emergency Surgery] Associate Chair Department of Surgery Director Surgical Critical Care University of Michigan Medical System, University of Michigan Medical System, 1C421 University Hospital, 1500 E. Medical Center Drive, Box 0033, 48109-0033, Ann Arbor, MI, USA

    Lena M. Napolitano (Professor of Surgery)

Authors
  1. Lena M. Napolitano
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Editor information

Editors and Affiliations

  1. Department of Surgery, Deputy Director, Comprehensive Cancer Center University of Alabama School of Medicine, Birmingham, AL, USA

    Kirby I. Bland MD (Fay Fletcher Kerner Professor and Chairman) (Fay Fletcher Kerner Professor and Chairman)

  2. Department of General and Visceral Surgery, University of Heidelberg, Heidelberg, Germany

    Markus W. Büchler MD (Professor of Surgery and Chairman) (Professor of Surgery and Chairman)

  3. Department of Surgery, University Hospital, Santiago, Chile

    Attila Csendes MD, FACS (Hon) (Professor of Surgery and Chairman) (Professor of Surgery and Chairman)

  4. James C. Mason Professor of Surgery Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA

    Michael G. Sarr MD

  5. Department of Clinical and Surgical Sciences, The University of Edinburgh Royal Infirmary of Edinburgh, Edinburgh, UK

    O. James Garden MBChB, MD, FRCS (Ed), FRCP (Ed), FRACS (Hon) (Regius Professor of Clinical Surgery) (Regius Professor of Clinical Surgery)

  6. Department of Surgery, The University of Hong Kong Queen Mary Hospital, Hong Kong, China

    John Wong BSc (Med (Syd)), MBBS (Syd), PhD (Syd), MD (Hon (Syd)), FRACS, FRCS (Edin), FRCS (Glasg), FACS (Hon) (Chair Professor) (Chair Professor)

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Napolitano, L.M. (2009). Gastrointestinal Failure. In: Bland, K.I., Büchler, M.W., Csendes, A., Sarr, M.G., Garden, O.J., Wong, J. (eds) General Surgery. Springer, London. https://doi.org/10.1007/978-1-84628-833-3_29

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  • DOI: https://doi.org/10.1007/978-1-84628-833-3_29

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-832-6

  • Online ISBN: 978-1-84628-833-3

  • eBook Packages: MedicineReference Module Medicine

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