Gastric infarction is rare, owing to the extensive collateral circulation of the stomach. A case of gastric infarction occurring in a patient with septic shock secondary to pneumonia is presented. The aetiology, diagnosis and therapy of gastric infarction are discussed, with consideration of the role of sepsis and vasopressors in pathogenesis and the concept of splanchnic resuscitation in prevention of the condition.
RuokonenE., TakalaJ., KariA., SaxenH., MertsolaJ., HansenE.J.Regional blood flow and oxygen transport in septic shock.Crit Care Med1993; 21: 1296–1303.
2.
ReillyP.M., WilkinsK.B., FuhK.C., HaglundU., BulkleyG.B.The mesenteric response to circulatory shock: an overview.Shock2001; 15: 329–343.
3.
GajicO., UrrutiaL.E., SewaniH., SchroederD.R., CullinaneD.C., PetersS.G.Acute abdomen in the medical intensive care unit.Crit Care Med2002; 30: 1187–1190.
GibbonsJ.R.P., McGuiganJ.Delayed infarction of the stomach following diaphragmatic injury.Injury1997; 28: 690–692.
12.
CohenE.B.Infarction of the stomach. Report of three cases of total gastric infarction and one case of partial infarction.Am J Med1951; 11: 645–652.
13.
HarveyR.L., DoberneckR.C., BlackW.C.Infarction of the stomach following atheromatous embolization.Gastro-enterology1972; 62: 469–472.
14.
RodgersJ.B.Infarction of the gastric remnant following subtotal gastrectomy.Arch Surg1966; 92: 917–921.
15.
BradleyEL3rd, GoldmanM.L.Gastric infarction after therapeutic embolization.Surgery1976; 79: 421–424.
16.
AlvesM., PatelV., DouglaE., DeutschE.Gastric infarction: a complication of selective vasopressin infusion.Dig Dis Sci1979; 24: 409–413.
17.
CoxM.R., MillarD.M.Gastric, hepatic and small bowel infarction due to radiation aortitis in a 42 year old woman.Aust NZ J Surg1993; 63: 499–501.
18.
ScholefieldJ.H., GoodmanA.J., MorganW.P.Abdominal wall and gastric infarction in acute pancreatitis.Pancreas1988; 3: 494–496.
19.
BabkinB.P., ArmourJ.C., WebsterD.R.Restoration of the functional capacity of the stomach when deprived of its main arterial blood supply.Can Med Assoc J1943; 48: 1–10.
KoyazoundaA., Le BaronJ.C., AbedN., DaussyD., LafarieM., PinsardM.Gastric necrosis caused by acute gastric dilatation. Total gastrectomy. Recovery.J Chir (Paris).1985; 122: 403–407.
22.
OudL., HauptM.T.Persistent gastric intramucosal ischemia in patients with sepsis following resuscitation from shock.Chest1999; 115: 1390–1396.
23.
ReineltH., RadermacherP., KieferP.Impact of exogenous beta-adrenoreceptor stimulation on hepato-splanchnic oxygen kinetics and metabolic activity in septic shock.Crit Care Med1999; 27: 325–331.
24.
LeDouxD., AstizM.E., CarpatiC.M., RackowE.C.The effect of perfusion pressure on tissue perfusion in septic shock.Crit Care Med2000; 28: 2729–2732.
25.
HolmesC.L., PatelB.M., RussellJ.A., WalleyK.R.Physiology of vasopressin relevant to management of septic shock.Chest2001; 120: 989–1002.
26.
MitchellA., CollinJ.Vasopressin effects on the small intestine: a possible factor in paralytic ileus?Br J Surg1985; 72: 462–465.
27.
SilvaE., DeBackerD., CreteurJ., VincentJ.L.Effects of vaso-active drugs on gastric intramucosal pH.Crit Care Med1998; 26: 1749–1758.
28.
KernH., SchroderT., KaulfussM., MartinM., KoxW., SpiesC.Enoximone in contrast to dobutamine improves hepato-splanchnic function in fluid-optimized septic shock.Crit Care Med2001; 29: 1519–1525.
