Mesenteric Ischemia

https://www.youtube.com/watch?v=cPNWYmuwPMc

Mesenteric ischemia

A condition caused by a lack of blood flow through the mesenteric vessels supplying the intestines, resulting in intestinal ischemia.

Celiac artery (T12)

The branch of the abdominal aorta that supplies the foregut, which includes the stomach, part of the duodenum, biliary system, liver, pancreas, and spleen.

Superior mesenteric artery (L1)

The branch of the abdominal aorta that supplies the midgut, spanning from the distal part of the duodenum to the first 2/3’ of the transverse colon.

Inferior mesenteric artery (L2)

The branch of the abdominal aorta that supplies the hindgut, spanning from distal 1/3 of the transverse colon to the upper rectum.

Chronic mesenteric ischemia

Also known as intestinal angina, a condition resulting from the narrowing of mesenteric blood vessels by atherosclerosis, leading to intermittent abdominal pain where blood supply cannot keep up with demand.

chronic mesenteric ischemia

TRIAD:

• central colicky abdominal pain

  • starting around 30 minutes after eating and lasting 1 to 2 hours,

• weight loss due to food avoidance,

• ± abdominal bruit.

Abdominal bruit

A whooshing or blowing sound heard on auscultation caused by turbulent blood flow through narrowed blood vessels.

CT angiogram

The diagnostic imaging test used for chronic mesenteric ischemia involving an intravenous contrast injection to highlight blood vessels and detect narrowing or abnormalities.

Percutaneous mesenteric artery stenting

A first-line endovascular revascularization procedure where a stent is inserted into a narrowed mesenteric blood vessel to restore blood flow.

Acute mesenteric ischemia

A condition typically caused by a rapid blockage in blood flow through the superior mesenteric artery, usually due to a thrombus or embolus.

Atrial fibrillation (in acute mesenteric ischemia)

A key risk factor where a thrombus forms in the left atrium and mobilizes down the aorta into the superior mesenteric artery, cutting off intestinal blood supply.

Metabolic acidosis with raised lactate

The characteristic arterial blood gas finding in acute mesenteric ischemia resulting from tissue ischemia and subsequent anaerobic respiration.

Acute mesenteric ischemia mortality rate

A high mortality rate of over 50 percent.