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Gastric intramucosal pH as a monitor of gut perfusion after thrombosis of the superior mesenteric vein
Author(s) -
Ruettimann U.,
Urwyler A.,
Von Flue M.,
Reinhardt D.,
Pargger H.
Publication year - 1999
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.1999.430716.x
Subject(s) - medicine , laparotomy , superior mesenteric vein , thrombosis , perfusion , mesenteric vein , ischemia , radiology , venous thrombosis , surgery , cardiology , portal vein
Gastric intramucosal pH (pHi) when measured by a tonometer is a simple and minimally invasive method to determine gut ischemia. In a case of severe mesenteric venous thrombosis, we measured pHi intra‐ and postoperatively over a period of five days. The goal was to monitor improvement or deterioration of gastrointestinal perfusion in the intensive care unit and to perform a second‐look laparotomy if the condition worsened. We observed that gastric pHi is a more sensitive parameter for detecting intestinal ischemia than parameters such as arterial pH, base excess, or lactate. This patient’s pHi rose continuously, which allowed us to proceed in a conservative way without any further invasive diagnostic interventions. Thus, the application of a gastric tonometer in cases of mesenteric venous thrombosis may help to reduce costs by preventing unnecessary postoperative diagnostic maneuvers such as angiography, computed tomography, or even second‐look laparotomy.