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Master Thesis

Ischémie mésentérique aiguë en soins primaires. Proposition de critères diagnostiques et d'éléments de prise en charge initiale à l'usage du médecin généraliste

Abstract : Acute mesenteric ischemia (AMI) is a rare medico-surgical emergency with high morbidity and mortality in the absence of diagnosis and early management. Its initial clinical presentation is nonspecific, in the form of abdominal pain, one of the most frequent reasons for visits to general medicine and emergency rooms. Based on a case encountered, and in the light of a review of the current scientific literature, we propose to develop a summary on the modern management of AMI for primary care physicians. We will also do an aside on this condition in athletes (exertion AMI), in view of the preponderance of sports patients in our practice as military doctors. The gold standard diagnostic test is a CT angiography. Three predictive criteria for acute late mesenteric ischemia are proposed: hyperlactatemia> 2 mmol / L, organ failure and signs of severity on imaging. Early, aggressive and multidisciplinary management is essential. It is based on the multi-stages pathophysiology of AMI and combines medical resuscitation and vascular and digestive surgical management. It aims to prevent multiple organ failure through medical treatment, preservation of the intestine through revascularization and resection of necrotic segments. This protocol-based treatment stems from recent international recommendations and has demonstrated its effectiveness in the latest studies with a clear reduction in morbidity and mortality.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03113372
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Submitted on : Monday, January 18, 2021 - 12:35:34 PM
Last modification on : Tuesday, February 2, 2021 - 3:12:13 AM
Long-term archiving on: : Monday, April 19, 2021 - 6:48:44 PM

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Maïlys Fromentin. Ischémie mésentérique aiguë en soins primaires. Proposition de critères diagnostiques et d'éléments de prise en charge initiale à l'usage du médecin généraliste. Médecine humaine et pathologie. 2020. ⟨dumas-03113372⟩

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